71. PORT OF LONDON SANITARY COMMITTEE. ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH, To 31st December, 1915. Presented, 13th April, 1916. REPORT, For the Year ended 31st December, 1915, OF THE MEDICAL OFFICER OF HEALTH FOR THE POST OF LONDON. by WILLOUGHBY MASON WILLOUGHBY, B.A., M.D., B.C., Cantab., D.P.H. Camb., Medical Officer of Health, Port of London. LONDON: Painted by Charles Skipper & East, 49, Great Tower Street, E.C, WAKEFIELD, Mayor. A Common Council holden in the Chamber of the Guildhall of the City of London, on Thursday, the 13th day of April, 1916. BELL. To the Right Honourable the Lord Mayor, Aldermen and Commons of the City of London, in Common Council assembled. THE Port of London Sanitary Committee did this day deliver into this Court a Report in writing under their hands, of their proceedings, and submitting the Annual Report of the Medical Officer of Health of the Port to the 31st December, 1915 ; which was read. Ordkred, That the Report be printed, and a copy sent to every Member of this Court. BELL. To the Right Honourable the Lord Mayor, Aldermen and Commons of the City of London, in Common Council assembled. WE, whose names are hereunto subscribed, of your Port of London Sanitary Committee, to whom it has been referred to carry into execution the powers assigned to the Corporation, as the Port of London Sanitary Authority by the Local Government Board, under the Public Health (London) Act, 1891, beg to submit for the information of your Honourable Court the Annual Report of the Medical Officer of Health for the Port of London, for the year ended the 31st December, 1915, which Report contains a full and detailed account of the work done in the Port during that period by the Medical Officers and Inspectors. The number of vessels medically inspected at Gravesend is higher than usual, showing that additional work has devolved upon your Medical Officers, the reduction in the number of these being largely here met by the practical suspension o£ Medway inspections. With reference to Infectious Disease, there is little to report as to Cholera, Yellow Fever and Plague, though with regard to the latter, the customary precautions by way of destruction and bacteriological examination of rats, fumigation of vessels, &c., have continued throughout the year. Small-pox is given some notice in special relation to a group of cases admitted to the Denton Hospital. Other Infectious Diseases do not call for special mention, except perhaps Pulmonary Tuberculosis, for the reason that though the Port Sanitary Authority is not specifically included in the provisions of the Regulations, yet cases are dealt with on arrival as if the Regulations were applicable, i.e., the notification to the Medical Officer of Health concerned is carried out. The Shell Fish Regulations of the Local Government Board impose important duties on the Port Sanitary Authority in reference to the control of shell-fish layings both public and private. Food Inspection has been carried out in a satisfactory manner. During the summer your Officers were called upon to deal with a very large quantity of unsound meat from a damaged steamer—the condition of most of the meat being offensive. With the co-operation of the parties interested, the material was disposed of without serious nuisance arising. No legal proceedings were necessary during the year. The appearance of abnormal conditions in relation to food stuffs, or diseases in meat, has not been marked by any cases of importance. The duties in relation to Sanitary Inspection and Canal Boats have been carefully carried out, and have resulted in the abatement of numerous nuisances both on vessels and on premises within the docks, &c. The fumigating apparatus has been frequently in use, the total tonnage fumigated being approximately 37,500 tons. Attention is called to the condition of the boarding hulk "Hygeia," which was the cause, during the summer, of serious inconvenience and expense. The hulk is old, and of wood, and therefore likely at any time to become leaky. (During a recent gale the straining at the moorings appears to have caused a considerable inlet of water, but the hulk has re-tightened completely.) A special report of the working of the Canal Boats Acts Regulations is included in the Repoit, and an account of receipts and expenditure in connection with the Port of London Sanitary Authority, for the year ended 31st December, 1915, is also appended, in accordance with the Order of your Honourable Court, for the information of the Court, All which we submit to the judgment of your Honourable Court. Dated this fourth day of April, 1916. Cecil F. J. Jennings. Hugh Shirreff. Robt. Peachey. Edward Ansted. J. K. Brown. W. Fortescue. A. C. Stanley Stone. Walter H. Key. James Wann. H. Percy Moncktoi Lewis M. Myers. William P. Neal. Fred. G. Dray. T. Robinson. E. S. Beal. C. C. Hodges. Clarence Hayden. John F. Bennet. OFFICES of the Port of London Sanitary Authority and Medical Officer of health at 51, KING WILLIAM STREET, GREENWICH, s.E. Telegraphic Address " MEDOFF, GREEN," LONDON. Telephone No. GREENWICH 360. BOARDING STATIONS. RIVER THAMES Hulk "Hygeia," Gravesend. RIVER MEDWAY Garrison Point, Sheerness. Telephone No. (Hulk "Hygeia") GRAVESEND 325. HOSPITAL FOR INFECTIOUS DISEASES at DENTON, near GRAVESEND. Telephone No. (Hospital) GRAVESEND 957. Ditto (Medical Officer in Charge) „ 86 1915. PORT OF LONDON SANITARY COMMITTEE. Mr. H. Percy Monckton (Chairman), Walbrook. ALDERMEN. Sir Walter Wilkin, K.C.M.G-. Sir T. Yansittart Bowater, Bart. Sir Walter Vaughan Morgan, Bart. Sir John James Baddeley, Knt. Sir William Purdie Treloar, Bart. Lt.-Col. Sir John Htjmphery, Knt. COMMONERS. Richard Green, Esq., J.P. Aldersgate. Mr. Harold Elliott Sparks Aldgate. Mr. Clarence Hayden Bassishaw. Edward Ansted, Esq., Deputy Billingsgate. Mr. Ihohas Robinson Mr. Arthur-Carlyon Stanley Stone Bishopsgate. Simon David Coates, Esq., J.P., Deputy read Street. Mr. Ernest Samuel Beal Bridge. Mr. Stephen Henry Molyneux Killik Broad Street. George Rowland Blades, Esq., J.P Candlewick. Mr. James Wann Castle Baynard. Col. John William Beningfield Cheap. Mr. George Billings Coleman Street. Mr. Edward Hughes Cordwainer. Mr. Thomas Goldney Cornhill. Sir Robert Hargreaves Rogers, Knt., Deputy Cripplegate Within. Mr. George Thomas Sirrell Tranter Cripplegate Without. Mr. Albion Thomas Snell Dowgate. © Mr. Robert Peachey N.S. Farringdon Within. Walter Fortescue, Esq., J.P S.S. Farringdon Within. Walter Henry Key, Esq., J.P N.S. Farringdon Without. Mr. Hugh Shirreff S.S. Farringdon Without. Mr. Henry Martin Gaydon Langbourn. John Knott Brown, Esq., Deputy Lime Street. Lewis Michael Myers, Esq., Deputy Portsoken. Mr. Edgar Edwin Bond Queenhithe. William Walter Green Esq., J.P. Tower. Col. Vickers Dunfee, Deputy Vintry. Corporation Representatives on the Port of London Authority and Thames Conservancy B oard (ex-officio Members of the Committee) :— Mr. Jaiies William Domoney, L.C.C. Mr. Horace Spencer Dove. Mr. Alfred Jerrold-Nathan (late Chairman). 4 INDEX. page Actinomycosis 37 Beef 36 Beri-Beri 30 Biscuits and Confectionery 42 Canal Boats Acts 54 Cerebro-Spinal Meningitis 30 Chicken-pox 29 Cholera 12 Cholera, Yellow Fever and Plague 12 Committee—List of Names 3 Condiments and Spices 43 Continued Fever 25 Crew's Quarters 48 Diphtheria 20 Disinfection 11 Disinfection of Military Stores 12 Drugs 43 Eggs 43 Enteric Fever 21 Erysipelas 25 Fish 40 Food Inspection 36 Foreign Meat Regulations 44 Fruit 40 Fumigation to destroy Rats £2 Grain 43 Hospital 32 Incoming Yessels—Cases of Illness on 31 Infectious Disease 9 Introductory 7 Launches 53 page Meal and Flour 43 Measles 24 Measles and Enteric Fever 24 Medical Inspection 8 Mutton and Lamb 37 Notification of Infectious Disease 31 Nuisances 48 Nuts 41 Offal 38 Offensive Cargoes 51 Plague among Rats 14 Pork 38 Port, Extent of, &c. 53 Poultry and Game 39 Provisions 42 Rabbits 39 Rat Plague 14 Sanitary Conveniences, &c. 50 Sanitary Inspection 45 Scarlet Fever 20 Shellfish 32 Small-pox 15 Smoke Nuisances 46 Smoked and Salted Meats 39 Staff 6 Steam Launches, &c. 53 Sundry Food Stuffs 43 Tinned Meats 39 Tuberculosis (Pulmonary) 27 Unsound Food 4 Vegetables 41 5 INDEX TO TABLES. table. page I. Medical Inspection—Gravesend 8 II. Ditto —Sheerness 8 III. Infectious Disease—Summary 9 IV. Compulsory Notification of Infectious Disease, with number of Deaths 10 V. Vessels and premises disinfected 11 VI. Effects disinfected 11 VII. Cholera 12 VIII. Rats destroyed—Return of 13 IX. Plague—Rats, Bacteriological Examination of 14 X. Small-pox 14 XI. Scarlet Fever 19 XII. Diphtheria20 XIII. Enteric Fever 21 XIV. Measles 22 XV. German Measles 24 XVI. Erysipelas 24 XVII. Continued Fever 25 XVIII. Pulmonary Tuberculosis 25 XIX. Miners' Phthisis 28 XX. Tuberculosis—other kinds 28 XXI. Chicken-pox 29 XXII. Cerebro-Spinal Meningitis 30 XXIII. Mumps 30 XXIV. Blackwater Fever 30 XXV. Beri-Beri 30 XXVI. Hospital—Admissions, Discharges and Deaths 32 XXVII. Unsound Food destroved 34 XXVIII. Unsound Meat—Weights of 35 XXIX. Foreign Meat Regulations—Notices 44 XXX. Sanitary Inspection—Summary 45 XXXI. Nuisances 46 XXXII. Ditto 47 XXXIII. Police Court Proceedings 49 XXXIV. Sanitary Works 50 XXXV. Offensive Cargoes 51 XXXVI. Fumigation of Vessels 52 XXXVII. Canal Boats 61 Appendix. A. Notes on Epidemic of Small-pox at Denton Hospital62 B. Statement of Receipts and Expenditure 65 6 STAFF. List of Officers forming the Staff of the Port of London Sanitary Authority, 31st December, 1915. Office. Name of Officer. Date of Appointment to Present Position. Condition as to Military Service. (See footnote.) MEDICAL OFFICER OF HEALTH - Herbert Williams, M.D.Lond., M.R.C.S., L.R.C.P., D.P.H. Camb. June, 1901 0. DEPUTY W. M. Willoughby, B.A., M.D., B.C., D.P.H.Camb. 1915 A. ASSISTANT MEDICAL OFFICERS— J. S. Warrack, M.A., M.D., C.M. Aberdeen, D.P.H.Camb. April, 1903 O.H.M.S. W.R.Betenson,M.R.C.S.,L.R.C.P.. Lond., D.P.H. Lond. July, 1907 0. Gravesend A. Kidd, M.R.C.S., L.R.C.P., Lond., D.P.H. 1909 0. Sheeuhess E. V. Legge, M.A., M.D., B.C., B.A.O., L.M.Dublin. 1909 0. GREENWICH OFFICES— Clerk W. J. Albrow March, 1890 0. 1st Assistant E. A. Sorrell October, 1894 0. (V.T.C.). 2nd ditto W. C. Barham June, 1903 A. Junior ditto Ditto T. J. S. Cotterell J. A. Gillis Julv, 1910 April, 1914 0.H.M.S. A. Caretaker F. Hudgell November, 1906 0. FOOD INSPECTORS *11. Spadaccini, Cert.R.San.Inst. July, 1898 0. *W. Anderson, Cert.R.San.Inst. July, 1898 0. *T. W. Bailey, Cert.R.San.Inst. July, 1901 0. SANITARY INSPECTORS *A. Garland, Cert.R.San.Inst. May, 1894 0. *W. G. Wetjen, Cert.R.San.Inst. August, 1898 0. *W. W. Burr, Cert.R.San.Inst. August, 1898 0. i i. R. Hopkins, Cert.R.San.Inst February, 1899 0. (R.N.A.S.), *P. R. Lambe, Cert.R.San.Inst. January, 1900 0. .1. H. Rolfe, Cert. R.San.Inst. September, 1901 0. *W. Ehvard, Cert.R.San.Inst. March, 1909 0. *F. J. Massie, Cert.R.San.Inst. March, 1909 A. C. A. Shepherd, Cert.R.San.Inst. January, 1909 0. H.M.S. W. J. Berry, Cert.R.San.Inst. February, 1914 A. DENTON HOSPITAL— Medical Officer W. M. Willoughby, B.A., M.D., B.C., D.P.H. Camb. November, 1908 A. Nurse Matron J. Jackson February, 1910 F. Assistant Nurse Ditto G. D. Beighton M. A. Thomas June, 1915 December, 1915 F. F. Ditto (Temporary) A. Foggo September, 1915 F. Ward Maid - L. Dunn May, 1915 F. Cook A. Hyde June, 1915 F. Maidservant - E. Hutson July, 1914 F. Caretakers - A. E. R. Lewis December, 1914 0. E. S. Lewis December, 1914 F, STEAM LAUNCHES— '' Lady Truscott "— Master W. Jarvis April, 1911 0. Engineer J. A. Hardman December, 1911 0. Mate A. F. Rough November, 1914 A. Stoker A. E. Howard February, 1912 0.H.M.S. " David Burnett "— Master C. H. Price October, 1913 O.H.M.S. Engineer J. Steen September, 1914 - A. Deckhand - J. Baulsom March, 1913 O.H.M.S. Stoker C.Wilcox December, 1911 - O.H.M.S. " George Briggs "—Motor Launch— Master C. Strange October, 1913 A. Engineer W. H. Buzzel September, 1914- D.M.U. (R.N.). GREENWICH MOORINGS- FUMIGATING BARGE "THOMAS"— Stoker, &c W. H. Buzzel September, 1914- D.M.U. (R.N.). BARGE "COLLING WOOD"— W atchmen H. A. Clarkson May, 1912 - O.H.M.S. • E. Ditch December, 1914 - D.M.U.(RN-)- GRAVESEND— H. E. Martin (Temporary) July, 1914 - 0. HULK "HYGEIA"— Shipkeeper I. Rogers April, 1893 0. Ditto - A. Salter - July, 1898 - 0. * These Inspectors possess the Special Certificate of the Royal Sanitary Institute for Inspectors of Food. Note.—O.H.M.S. Active Service, A. Attested. 0. Overage. F. Female. D.M.U. Discharged, Medically Unfit. 7 PORT OF LONDON SANITARY OFFICES, 51, KING WILLIAM STREET, GREENWICH, S.E. TO THE WORSHIPFUL THE PORT OF LONDON SANITARY COMMITTEE. Gentlemen, I have the honour to present herewith the Annual Report of the Medical Officer of Health for the year 1915, being the fourteenth of the series. I have to record the sad loss your Committee have sustained by the death of your late Medical Officer of Health, Dr. Herbert Williams, which occurred after a very short illness on the 16th January, 1916, while this Report was in course of preparation. The Report, therefore, on this occasion will lack the personal note which is imparted by the Officer under whose supervision the work comprised in the following pages has been actually carried out. Following the lines of past Reports, however, I give a few notes by way of general comment on the year's work, supplemented where convenient by such facts as have come within my personal knowledge. The total number of vessels arriving in the Port of London, from "foreign" during the year, was 7,161 at Gravesend, and 96 at Sheerness, the average for the past ten years being 9,194.6 at Gravesend, and 299.7 at Sheerness. Of the total arrivals, 2,393 were medically inspected at Gravesend, and 58 at Sheerness. The details of these figures are given in Tables I. and II. Compared with the average for the past ten years, the percentage of arrivals medically inspected during 1915, namely 33 per cent., represents an increase on the average of about 6 per cent., and shows that closer medical supervision was desirable, and therefore more work than usual has devolved upon your Medical Officers. Infectious Disease is dealt with in Tables III. to XXVI. Food Inspection is specially dealt with; full particulars will be found in Tables XXVII. to XXIX. Sanitary Inspection is summarised in Tables XXX. to XXXV. 8 TABLE I. MEDICAL INSPECTION—GRAVESEND. From 1st January to 31st December, 1915. Jan. Feb. March April May June July Aug. Sept. Oct. Nov. Dec. Total. Number of foreign arrivals 512 429 603 513 625 850 681 619 594 622 562 551 7,161 Number medically inspected 211 177 212 151 193 248 194 231 214 191 205 166 2,393 Number of passengers 8,893 4,840 5,745 3,292 4,953 7,248 6,291 4,473 4,179 4,728 4,160 2,235 61,037 Number of crew 9,273 6,526 9,032 5,651 8,475 12242 7,863 8,501 8,967 8,011 10080 8,336 102957 COMPARATIVE TABLE. GRAVESEND. 1906. 1907. 1908. 1909. 1910. 1911. 1912. 1913. 1914. Mean annual number for the 10 years ending 31st December, 1915. 1915. Number of foreign arrivals 9,955 9,639 9,559 9,571 9,699 9,543 9,107 9,727 7,985 9,194.6 7,161 Number of vessels medically inspected 2,853 2,700 2,840 2,248 2,756 2,744 2,366 1,948 1,976 2,482.4 2,393 Total number medically inspected at Gravesend— From August, 1892, to December, 1914 57,115 „ 1st January to 31st December, 1915 2,393 Total 59,508 TABLE II. MEDICAL INSPECTION—SHEERNESS. From 1st January to 31st December, 1915. Jan. Feb. March April May June July Aug. Sept. Oct. Nov. Dec. Total. Number of foreign arrivals 6 1 6 5 7 7 13 8 12 14 11 6 96 Number medically inspected — — 1 — 4 1 2 8 12 13 11 - 6 58 Number of passengers — — — — — — — - — — — — Number of crew 39 46 198 54 145 130 — - — 25 124 — 761 COMPARATIVE TABLE. SHEERNESS. 1906. 1907. 1908. 1909. 1910. 1911. 1912. 1913. 1914. Mean annual number for the 10 years ending 31st December, 1915. 1915. Number of arrivals 375 376 319 337 337 292 266 324 265 299.7 96 Number of vessels medically inspected 320 325 279 285 284 259 237 268 186 250.1 58 Total number medically inspected at Sheerness— From 1st September, 1894, to 31st December, 1914 5,814 ,, 1st January to 31st December, 1915 58 Total 5,872 9 TABLE III.—INFECTIOUS DISEASE. Disease. 1906. 1907. 1908. 1909. 1910. 1911. 1912. 1913. 1914. Mean annual number for 10 years ending 31st December. 1915. 1915. (a) Cases reported : Cholera (including suspected cases) 3 9 5 3 5 9 2 19 ... 5.7 2 Yellow Fever (ditto) 2 ... 2 ... ... ... ... 4 ... 0.8 ... Plague (ditto) 9 4 1 4 6 ... 9 4 4 4.1 ... Small-pox 31 27 16 27 8 13 34 19 9 23.1 47 Scarlet Fever 82 44 23 16 21 11 10 40 30 29.5 18 Diphtheria 7 7 18 11 11 18 37 16 10 15.3 18 Enteric Fever 81 55 90 36 39 70 61 65 67 62.8 64 Measles 68 51 86 19 23 175 61 64 228 111.2 337 German Measles ... ... ... ... ... ... 3 4 ... 1.7 10 Erysipelas 7 2 7 5 5 11 3 3 3 5.5 9 Typhus Fever ... ... ... ... ... ... 1 ... ... 0.1 ... Continued Fever 11 11 19 10 1 5 9 13 2 8.8 7 Relapsing Fever ... ... ... 1 ... ... ... ... ... 0.1 ... Tuberculosis :— Pulmonary ... ... ... ... ... ... 71 151 127 445. 96 Other kinds ... ... ... ... ... 7 45 5.8 6 Other diseases (including Chickenpox). Total 35 42 41 57 25 38 42 38 50 41.6 48 336 252 308 189 144 350 343 447 575 360.6 662 (b) Treated in Port Sanitary Hospital: Cholera (including suspected cases) ... 1 ... 1 2 ... ... ... ... 0.4 ... Yellow Fever (ditto) ... ... ... ... ... ... ... ... ... ... ... Plague (ditto) 1 3 ... 1 2 ... 1 2 1 1.1 ... Small-pox ... 8 ... 4 2 6 2 9 2 4.3 10 Scarlet Fever 28 4 6 14 ... 6 ... 3 8 7.9 10 Diphtheria 1 3 5 1 4 3 ... 7 1 2.8 3 Enteric Fever 26 27 42 11 17 22 35 29 30 25.6 17 Measles 3 14 13 5 2 7 27 18 9 13.1 33 Erysipelas 1 ... 1 1 ... ... 1 ... ... 0.5 1 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... Continued Fever 7 10 6 10 1 4 7 9 1 6.0 5 Other diseases (including Chickenpox). Total 21 5 15 10 7 8 7 14 9 11.0 11 91 75 88 58 37 56 80 91 61 72.7 90 10 TABLE IV. Return of the Number of Cases of Infectious Disease Notified to the Local Government Board during the Year 1915, and of Deaths from the Diseases Notified : — Notified. Deaths. Small-pox 10 2 Scarlet Fever 17 ... Diphtheria (including Membranous Croup) 17 ... Enteric (Typhoid) Fever 24 ... Puerperal Fever ... ... Typhus Fever ... ... Cholera ... ... Relapsing Fever ... ... Continued Fever 5 1 Cerebro-Spinal Fever 5 1 Acute Poliomyelitis ... Erysipelas 9 ... Ophthalmia Neonatorum ... ... Tuberculosis : Pulmonary 37 ... Other kinds 5 ... Chicken-pox 15 ... Whooping Cough ... ... Measles 96 ... Other Diseases :— 4 ... 244 4 NUMBER OF NOTIFICATIONS DURING 1915. Small-pox :—Passengers 180 Crew 203 Total 383 Not traced—7 Passengers, 1 Crew. 11 TABLE Y. Vessels and Premises Disinfected, from 1st January to 31st December, 1915. Month. Reason for Disinfection. Total Number of Disinfections. Cerebro-Spinal Meningitis. Chicken-pox. Cholera. Continued Fever. Diphtheria. Enteric Fever. Erysipelas. Beri-Beri. Measles. Whooping Cough. Plague. Remittent Fever. Scarlet Fever. Small-pox. Pulmonary Tuberculosis, &c. Precautionary Measure. Vessels Fumigated andS prayed. January ... ... ... ... l 1 1 ... ... ... ... ... 1 ... 2 ... ... 6 February ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 1 ... 2 5 March ... 1 ... ... 2 5 ... ... 1 ... ... ... 1 ... 2 ... ... 12 April ... ... ... ... ... 1 ... ... 2 ... ... ... 2 ... 3 ... ... 8 May ... ... ... ... ... ... 1 ... 1 ... ... ... 1 1 2 ... ... 6 June ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 4 ... 1 6 July ... 1 ... 1 ... 1 ... ... ... ... ... ... 1 1 1 ... 1 7 August ... ... ... ... ... 2 ... ... 2 ... ... ... ... ... 2 ... 1 7 September ... ... ... ... ... 3 ... ... 1 ... ... ... 1 1 ... ... 1 7 October ... ... ... 1 ... 3 ... ... 1 ... ... ... ... ... 1 ... 2 8 November ... 1 ... ... 1 2 ... ... 2 ... ... ... ... ... 2 ... 2 10 December ... 1 ... 1 ... ... ... ... 1 ... ... ... ... ... 2 ... 1 6 Totals 4 3 4 19 2 11 ... 8 4 22 ... 11 88 TABLE VI. Number of Disinfections of Effects, Bedding, &c., from 1st January to 31st December, 1915. Month. Reason for Disinfection. Hospital Bedding, &c. Total Effects. Number of times Steam Disinfector was used. Disiufeeted by Fumigation. Cholera. Chicken-pox. Cerebro-Spinal Meningitis. Continued Fever. Diphtheria. Enteric Fever. Erysipelas. Measles. Pulmonary Tuberculosis, &c. Plague. Remittent Fever. Scarlet Fever. Small-pox. Precautionary measure. 1 January ... ... ... ... 1 ... 1 ... ... ... ... 1 ... ... ... 3 5 ... February ... ... 1 ... ... 1 ... ... 1 ... ... ... 2 ... 1 6 11 I March ... 1 ... ... 2 4 ... 1 2 ... ... 1 ... ... ... 11 10 3 April ... ... ... ... ... 3 ... 1 3 ... ... ... ... 1 2 10 12 2 May ... ... ... ... ... ... ... 1 ... ... 2 1 ... 1 5 10 ... June ... ... ... 1 ... ... ... ... 1 ... ... 1 ... ... 1 4 3 1 July ... ... ... 1 ... 1 ... ... 1 ... ... 1 1 ... 1 6 7 1 August ... ... ... ... ... 1 ... 2 ... ... ... ... ... ... 1 4 5 ... September ... ... ... ... ... 5 ... 1 ... ... ... 2 ... ... ... 9 7 ... October ... ... ... 1 ... 3 ... 1 1 ... ... ... ... ... ... 6 6 2 November ... 1 ... ... 2 2 ... 2 1 ... ... ... ... ... ... 8 8 ... December ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... 1 3 4 ... Totals ... 2 1 4 5 20 1 10 10 ... ... 8 0 ... 8 75 88 10 12 DISINFECTION OF MILITARY STORES. At the request of those in charge of the Royal Naval Store, West India Dock, the disinfection of a quantity of bedding returned from use into store, was undertaken as a precautionary measure. The transport of the material to Gravesend was undertaken by the Royal Naval Authorities, and the disinfection was satisfactorily carried out in the apparatus at Denton Hospital under the personal supervision of your Deputy Medical Officer. CHOLERA, YELLOW FEVER AND PLAGUE. Only two cases of Cholera were reported to have occurred on incoming ships. Both of these were from India and were landed at Colombo. No case of Yellow Fever or Plague was reported during the year. Cholera has been prevalent in Europe during the past year, especially Austria and Hungary, where many thousands of deaths have occurred from this cause. It would appear also that Germany has suffered from an outbreak attributed, by report, to infection from Russian prisoners of War. In some quarters it was, not perhaps unnaturally, feared that the presence of Indian troops in Europe might provoke an outbreak, but nothing of the kind occurred during 1915. With reference to Plague, the occurrence of this disease during the year in Mesopotamia, Syria, Asia Minor, and in Egypt, will engage due attention. TABLE VII. (Cholera.) Date. Name of Vessel. Port of Registry and Official No. Where from. No. of Cases. How dealt with. 1915. s.s. "Tactician," of Liverpool, 113,398. Calcutta 1 Landed at Colombo. Dec. 17 „ 29 s.s. "Knowsley Hall," of Liverpool, 118,058. Ditto 1 Ditto. Total 2 CHOLERA. The s.s. "Tactician" of Liverpool, 113,398, arrived at Gravesend on the 17th December, and reported having landed a case of Cholera at Colombo on the 16th November. Disinfection was carried out at Colombo, and the water tanks were pumped out and cleaned. No further suspicious case occurred, and all on board were well on arrival. The s.s. "Knowsley Hall," of Liverpool, 118,058, arrived on the 22nd December, and reported having landed a case suspicious of Cholera at Colombo on the 17th November. The patient, a Serang, was taken ill on the 16th November with diarrhasa, no vomiting or cramps. The vessel and water tanks were disinfected at Colombo, and no other case of illness has occurred. All wTere well on arrival at Gravesend. The facts were reported to the Local Government Board in each case. 13 TABLE VIII. Return of Rats caught and destroyed during 1915. The entire cost of destroying these rats has been borne by the Shipowners and Dock Companies. Jan. Feb. Mar. April. May. JuDe. July. Aug. Sept. Oct. Nov. Dec. Totals. Millwall Dock— Warehouses 260 127 170 104 177 128 119 142 144 32 130 907 2,440 Vessels during voyage — — 37 20 30 6 285 C 170 136 70 30 790 „ while in dock 51 71 60 33 29 55 176 136 219 181 244 270 1,525 Surrey Commercial Dk.— Warehouses 20 25 21 21 14 28 15 14 5 22 17 16 218 Vessels during voyage 12 20 — — 22 90 — — — — — — 144 „ while in dock 42 84 301 174 125 61 38 102 101 146 215 52 1,441 Regent's Canal Dock— Warehouses — — — — — — — — — — — — — Vessels during voyage — — — — — — — — — — — — — „ while in dock — — — — — — — — — — — — — St. Katharine's Dock— Warehouses 57 35 53 43 72 50 69 55 41 47 25 47 594 Vessels during voyage — — — — — — — — — — — — — „ while in dock - — — — — — — — — — — — — — London Dock— Warehouses 43 62 62 65 70 60 93 77 64 97 71 72 836 Vessels during voyage — — — — — — — — — — — — — „ while in dock — — — — — — — 15 22 — — — 37 Albert and Victoria Dks.— Warehouses 264 246 231 333 438 383 748 431 312 704 523 302 4,915 Vessels during voyage 39 975 1 50 97 517 63 89 134 145 424 12 2,546 ,, while in dock 613 621 612 646 665 754 1,047 724 770 782 576 756 8,596 West India Dock— Warehouses 61 90 48 31 51 74 39 33 47 55 82 66 677 Vessels during voyage 70 156 10 40 10 78 10 36 130 84 95 12 731 „ while in dock 190 584 379 348 272 397 165 519 384 490 364 308 4,400 East India Dock— Warehouses 12 7 23 16 17 11 23 20 25 24 12 53 243 Vessels during voyage — — — — — — — 30 30 — — — 60 „ while in dock 6 — 67 — — — 110 177 204 423 — 22 1,009 Tilbury Dock— W arehouses 138 157 162 129 173 105 190 144 178 731 217 186 2,510 Vessels during voyage 33 500 321 428 362 346 397 9 617 888 315 — 4,216 „ while in dock 469 332 430 270 291 461 507 171 183 536 420 425 4,495 River— During voyage — — — — — — — 60 — — — — 60 While in river — — — — — — — 8 — — — — 8 Totals 2,410 4,092 2,988 2,751 2,915 3,604 4,094 2,998 3,780 5,523 3,800 1 3,536 42,491 Total from February, 1901, to 31st December, 1914 - 837,097 Total from 1st January to 31st December, 1915 :— In Dock Warehouses - 12,433 On Vessels during voyage - - - 8,547 On Vessels while in Dock and River - 21,511 42,491 Total - - 879,588 11 TABLE IX. RETURN OF RATS EXAMINED BACTEBIOLOGICALLY, 1915. Dock. No. Trapped. Found Dead. Infected Eats: Trapped. Found Dead. Royal Albert 670 8 ... « » • Royal Victoria 902 43 ... ... East India 40 1 ... Millwall 167 ... ... ... West India 26 1 . ... ... Tilbury 92 2 ... ... London 373 5 ... ... Surrey Commercial 6 ... ... ... St. Katharine 548 ... ... ... Dock Unknown 68 1 ... ... 2,892 61 Nil. Nil. Summary— Total rats examined 2,953 „ „ infected Nil. 2.953 Species— Mus alexandrinus 76 Mus decumanus (Norvegicus) 2,239 Mus rattus 560 Mus musculus 5 Not classified 73 2,953 TABLE X. (Small-pox.) Date. Name of Vessel, Port of Registry and Official Number. Where from. No. of Cases. How dealt with, 1915. January 27 s.s. " Eumaeus," of Liverpool, 135,485. Shanghai 20 Landed at Penang, February 7 s.s. " City of Marseilles," of Liverpool, 135,436. Calcutt 7 Removed to Port Sanitary Hospital. 16 s.s. "Arabia," of Greenock, 105,581. Bombay 1 Landed at Suez. March 5 s.s. " Bencleugh," of Leitb, 109,605. Calcutta 1 Landed at Calcutta. 11 s.s. "Worcestershire," of Liverpool, 118,126. RaDgoon 1 Landed at Colombo. 14 s.s. " City of Birmingham," of Liverpool, 131,397. Calcutta 1 Ditto. 14 s.s. " Barotse," of London, 112,825. Melbourne 1 Landed at Aden. Forward 32 15 Date. Name of Vessel, Port of Registry, and Official Number. Where from. No. of Cases. How dealt with. 1915. Brought forward 32 April 2 s.s. "City of London," of Glasgow, 124,162. Calcutta 2 Landed at Colombo. ,, 17 s.s. "Malakand," of Liverpool, 120,907. Ditto 1 Landed at Suez. ,, 21 s.s. "City of Durham," of Liverpool, 131,317. Singapore 1 Landed at Singapore. ,, 22 s.s. "Clan Cumming," of Glasgow, 108,797. Coconada 1 Landed at Galle. May 10 s.s. "Werdenfels" (German Prize) Alexandria 1 Removed to Port Sanitary Hospital. ,, 28 s.s. "City of York," of Glasgow, 119,100. Calcutta 1 Landed at Colombo. ,, 31 s.s. "Novara," of Greenock, 131,860. Bombay 1 Landed at Karachi. June 9 s.s. " Khiva," of Liverpool, 135,533. Calcutta 1 Landed at Aden. ,, 9 s.s. '• Huntsman," of Liverpool, 118,103. Ditto 1 Landed at Suez. ,, 9 s.s. " HeleDUS," of Liverpool, 135,519. Yokohama 1 Landed at Colombo. ,, 17 s.s. "Wartenfels" (Prize Vessel) Calcutta 1 Ditto. July 6 s.s. " Arabia," of Greenock, 105,587. Bombay 1 Landed at Port Said. ,, 20 s.s. " Tagus," of Liverpool, 109,483. Oporto 1 Removed to Port Sanitary Hospital. Sept. 23 s.s. " Pallas " (Russian) Gandia 1 Ditto. Total 47 SMALL-POX. It would appear from Table III. that the number of cases of Small-pox dealt with was larger than usual, the number of cases reported being more than double the average. The number is, however, inflated by 20 cases reported in one vessel, these having occurred amongst pilgrims in Chinese waters. None arrived in this country. On the other hand a group of cases, seven in number, derived from Egypt, were admitted to Denton Hospital, and these cases, which came under direct observation of both your past and present Medical Officers, were instructive in a general as well as a medical sense, and I have dealt with the group at some length. The s.s. "Eumaeus," of Liverpool, 135,485, arrived on the 27th January, from Shanghai, when it was ascertained that, between the 9th and 20th November, 1914, there were 20 cases of Small-pox amongst Pilgrims on board, 5 of which proved fatal. The Pilgrims went ashore into quarantine at Penang, on the 20th November, 1914. The ship was disinfected, and the health of the crew was good during the remainder of the voyage. The s.s. "City of Marseilles," of Liverpool, 135,436, arrived at Gravesend on the 6th February. The vessel originally came from Calcutta, but at Port Said there embarked 10 passengers, consisting of a man, his wife, a lady companion, and seven children, who came from Jerusalem some weeks previously but had been staying in Egypt, and they joined the vessel at Port Said on the 25th January. One of the children was taken ill on the 27th January, and the father states that a rash appeared on the 29th, but apparently no complaint was made to the doctor on board, until the 31st, when the child was found to have a general confluent rash which was diagnosed as Small-pox. There were 12 other passengers in the second-class when the nature of the disease was recognised. The second-class accommodation was reserved for the isolation of the aforesaid 10 persons, with four stewards. On arrival at Gravesend, 16 the family of 10 were removed to Denton Hospital for observation, the patient being isolated in the Small-pox Ward. The four stewards were taken ashore, and disinfected, and the whole of the Native crew were vaccinated, but the Europeans on board declined to be done. The second-class quarters and contents were at once thoroughly disinfected. Of the seven children, the two eldest had been vaccinated, and each possessed one good vaccination mark. The other five had never been vaccinated previous to arrival and these five developed Small-pox, and were under treatment in Denton Hospital. The whole of the crew remaining on the vessel, were kept under observation daily. The bar tender, and carpenter, ailed, and were diagnosed as suffering with Small-pox, and were removed to Denton Hospital on the 13th February, making seven cases of Small-pox in all under treatment from this ship. The names and addresses of all persons leaving the ship, as well as those of the men engaged in discharging the ship, were taken and notified to the various Medical Officers of Health, and the facts were duly reported to the Local Government Board and London County Council. The following Table gives particulars of vaccination, rash, &c.:— Age. Rash. Vaccination. Nature of Rash. Remarks. Mr. L. 40 — 20 years ago — Fever, 4 days. Mrs. L. 36 — 17 „ — No symptoms. Miss S. 48 — Infancy, and twice since — Do. M.L. .13 — 7 years ago, one mark — Fever, 3 days. L.L. 12 — Do. — No symptoms. C.L. 10 Jan. 29th Nil Confluent P.L. 8 Feb. 11th Nil Do. M.L. 6 „ 13th Nil Do. M.L. 4 „ 14th Nil Discrete C.L. 14/12 „ 15th Nil Confluent R.H. 38 „ 13 th Infancy Do. C.G.C. 20 „ 12th Infancy Mild discrete Mr. L. and N. L. had some fever with backache and vomiting contemporaneously with the febrile periods of those members of family who subsequently developed a definite rash. A few spots of doubtful character came out on the back only of Mr. L., but no rash of any kind came out on N.L. These two cases were probably Small-pox without eruption. All the above persons, with the exception of 11.H., were vaccinated on 7th February, after the arrival of the vessel : of these, C.G.C., P.L., M.L., M.L., and C.L., "took " and developed concurrently with the disease, but they had been infected with the disease about 31st January, so that it could not be expected that vaccination would have any protection or even modifying effect on the course of the disease. The more specially medical aspect of this epidemic is referred to in the Appendix. The s.s. "Arabia," of Greenock, 105,581, arrived on the loth February from Bombay. A passenger was landed at Suez on the 31st January suffering with Small-pox. 17 A child was also landed at Plymouth, having been taken ill on the 26th January—the diagnosis was Chicken-pox. All names and addresses of passengers landing were taken and notified to the various Medical Officers of Health, and the vessel and effects were thoroughly disinfected by this Authority. The vessel was kept under daily observation while in the Port. The s.s. "Worcestershire," of Liverpool, 118,126, arrived from Rangoon on the 10th March, having landed a case of Small-pox at Colombo on the 9th February. All necessary disinfection was carried out, and no further case occurred. The Native crew and part of European crew were vaccinated. On arrival at Gravesend all on board were well. The s.s. " Bencleuch," of Leith, 109,605, arrived from Calcutta on the 6th March, having landed a case of Small-pox there. All necessary disinfection was carried out, and the crew were vaccinated. No further case occurred. All on board were well on arrival at Gravesend. On arrival of the s.s. " City of Birmingham,"of Liverpool, 131,397, from Calcutta, on the 14th March, it was ascertained that a case of Small-pox had been landed at Colombo on the 17th February. All necessary disinfection was carried out, and no further case occurred. On arrival at Gravesend all on board were found to be well. As a precautionary measure, however, I had the vessel kept under daily observation while in the Port. The s.s. "Barotse,"of London, 112,825, arrived from Melbourne on the 13th March, having landed a case of Small-pox at Aden on the 30th January. All necessary disinfection was carried out, and the crew were vaccinated. No further case occurred, and on arrival at Gravesend all on board were well. The s.s. "City of London," of Glasgow, 124,162, arrived from Calcutta on the 2nd April, having landed two cases of Small-pox at Colombo on the 11th March. All necessary disinfection was carried out there, and the European and Native crew were vaccinated. No further cases occurred, and on arrival at Gravesend all on board were found to be well. The s.s. "Malakand," of Liverpool, 120,907, arrived at Gravesend on the 2nd April, 1915, from Calcutta, and reported the landing of a case of Small-pox at Suez on the 19th March. All necessary disinfection was carried out there. The Native crew were vaccinated at Calcutta. On the 2nd April, a Lascar was found to have a rash, but no fever. The disease was diagnosed as Chicken-pox, and the man was isolated on board the vessel. On the 21st April, two more cases of Chicken-pox were discovered on this vessel, and isolated on board. As the cases observed since arrival have been Chicken-pox, it is probable that the, patient landed at Suez was also suffering from this disease, and not Small-pox. The s.s. "City of Durham," of Liverpool, 131,317, arrived at Gravesend on the 21st April, from Singapore having lauded a case of Small-pox there on the 8th March. All necessary disinfection was carried out, and the whole crew (European and Native) were vaccinated. No further cases occurred, and all were well on arrival at Gravesend. The s.s. "Clan Cumming," of Glasgow, 108,797, arrived on the 22nd April, from Coconada, having landed a case of Small-pox at Galle on the 11th March. All necessary disinfection was carried out, and the crew vaccinated. No further case occurred, and all were well on arrival at Gravesend. 18 The s.s. "Werdenfels" arrived from Alexandria on the 9th May, 1915, when a case of Small-pox was removed therefrom to Denton Hospital. The patient, a fireman, complained to the master on the 26th April of headache and " malaria," and constipation of three days' duration. Spots were on his face at time of complaint, temperature 103'5 degrees. On the 27th April, his temperature was normal, and he resumed duty. He was not logged as being ill. On the 30th April, he was seen by a doctor at Algiers, who said state was one of " bad blood." The master does not appear to have been aware of the nature of the illness, and therefore the case was not reported on arrival, but was discovered in the ordinary course of medical inspection at Gravesend. The whole of the crew of 56 persons were re-vaccinated, and the vessel and effects thoroughly disinfected. As the vessel had come from a port at which plague existed, the crew were only allowed to leave the vessel on furnishing satisfactory addresses, which were taken and notified to the various Medical Officers of Health. On the 16th May, information was received from the Medical Officer of Health for Bristol, that the cook of the vessel, whose name and address had been notified, sickened on arrival at Bristol, and was removed to hospital suffering from haemorrhagie Small-pox. Another of the crew was removed to hospital at Stepney, suffering from this disease, on the 17th May. The s.s. "City of York," of Glasgow, 119,100, arrived from Calcutta on the 26th May, and reported having landed a case of Small-pox at Colombo on the 1st May. The vessel and effects were disinfected, and the crew vaccinated. The s.s. "Novaro,"of Greenock, 131,860, arrived from Bombay on the 27th May, and reported having landed a case of Small-pox at Karachi on the 30th April. The vessel and effects were disinfected, and vaccination was carried out where necessary. The s.s. " Khiva," of Liverpool, 135,533, arrived from Calcutta on the 6th June, and reported having lauded a case of Small-pox at Aden on the 14th May. The vessel and effects were thoroughly disinfected, and vaccination carried out where necessary. The s.s. " Huntsman," of Liverpool, 118,103, arrived from Calcutta on the 8th June, having landed a case of Small-pox at Suez on the 23rd May. The vessel and effects had been disinfected, and the crew vaccinated. The s.s. " Helenus," of Liverpool, 135,519, arrived from Yokohama on the 8th June, having landed a case of Small-pox at Colombo on the 13th May. The ship's hospital was disinfected, and effects taken ashore with patient. The bedding was destroyed. All persons on board were re-vaccinated at Colombo. The s.s. " Wartenfels " arrived from Calcutta on the 16th June, having landed a case of Small-pox at Colombo on the 13th May. The vessel was disinfected, and the crew vaccinated. Bedding and effects were taken ashore with patient. The s.s. "Arabia," of Greenock, 105,587, arrived at Gravesend on the 6th July from Bombay, and reported having landed a case of Small-pox at Port Said on the 22nd June. The vessel and effects were disinfected. No further case occurred. 19 The s.s. "Tagus," of Liverpool, 109,483, arrived on the 20th July from Oporto, when a cabin boy was found to be suffering from Small-pox. He was removed to Denton Hospital. All necessary disinfection was carried out, and the crew of 21, with the exception of three objectors, were re-vaccinated. The names and addresses of all members of the crew leaving the vessel were taken and notified to the respective Medical Officers of Health. No further case occurred. The Russian steamship "Pallas" arrived at Gravesend from Gandia on the 22nd September, 1915, when a case of Small-pox was removed therefrom to Denton Hospital. The patient, a fireman, was taken ill on the 18th September ; rash appeared the same day. Only three members of the crew accepted vaccination. All necessary disinfection has been carried out, and the crew remained on the vessel, which was kept under daily observation while in the Port. TABLE XI. (Scarlet Fever.) Date. Name of Vessel. Port of Registry, and Official Number. Where from. No. of Cases How dealt with. 1915. Jan. 12 s.s. " Geelong," of London, 118,426 Sydney 1 Removed to Port Sanitary Hospital. Feb. 5 Training Ship " Exmouth," lying off Grays 1 Removed to Brook Hospital (M.A.B.). March 19 Training Ship "Arethusa," lying off Greenhithe 1 Removed to Ship's Hospital on Shore. ,, 24 s.s. " Rumuera," of Plymouth, 124,590 Wellington 1 Removed to Port Sanitary Hospital. ,, 24 s.s. " Mecklenberg " (Dutch) Flushing 1 Ditto. April 16 s.s. "Graciana," of West Hartlepool, St. John's 118,054. 1 Removed to Kirkbymoorside Hospital. „ 22 Police Office, Royal Victoria Dock Removed to Plaistow Hospital. May 8 s.s. "Exmouth," of Cardiff, 109,787, lying in Surrey Commercial Dock. 1 Removed to Port Sanitary Hospital. ,, 11 Training Ship " Exmouth," lying off Grays 1 Removed to Eastern Hospital (M.A.B.). ,, 12 s.s. " Miltiades," of Aberdeen, 118,179 Brisbane 1 Removed to Port Sanitary Hospital. ,, 18 Training Ship " Arethusa," lying off Greenhithe 1 Removed to Bow and Arrow Hospital. ,, 18 s.s. " Mackinaw," of Liverpool, 97,837 Philadelphia 1 Removed to Port Sanitary Hospital. June 17 Barge "Colonia," of Harwich, 105,422 Ipswich 1 Ditto. July 12 No. 5, Pier Head Cottages, Millwall Dock 1 Ditto. ,, 22 Training Ship " Exmouth," lying off Grays 2 Removed to Eastern Hospital (M.A.B.). Aug. 4 s.s. "Commonwealth," of London, Sydney 115,903. 1 Allowed to proceed home convalescent. Sept. 13 s.s. " Ascania," of Liverpool," 131,342 Mudros 1 Removed to Port Sanitary Hospital. ,, 13 s.s. " Sote," of Gothenburg Halmstad 1 Ditto. 18 20 SCARLET FEVER. The s.s. "Graciana," of West Hartlepool, 118,054, arrived from St. John's on the 4th April, and proceeded to the Surrey Commercial Dock. The master reported "all well on board," and no sickness during the voyage. On the 13th April, information was received that an apprentice had returned to his home at Kirkbymoorside, from this vessel, and suffering from Scarlet Fever. It would appear that on the 25th March, this boy complained of a sore throat, and had a rise of temperature, and that he was isolated in a berth, and attended to by the master, who subsequently reported that the lad in question had been suffering from a " cold," and had been treated by medical men in St. John's and Halifax. After leaving Halifax, he complained of a sore throat, and had a rise of temperature, and was treated by him for "influenza." Subsequently the boy appeared to be well and resumed duty. The master did not think it necessary in the circumstances to report the case, for which, of course, he was to be blamed. A private in the Irish Guards, stationed at Caterham, visited his parents residing in the Royal Victoria Dock. He was not feeling well when he left Caterham, and travelled to London by train and by public conveyances to the Royal Victoria Dock. Feeling worse, he attended the Branch Seamen's Hospital in the Royal Albert Dock, and was there found to be suffering from Scarlet Fever, and was removed to the Isolation Hospital at Plaistow, belonging to the County Borough of West Ham. An offer of admission into Denton Hospital was made, but the patient was too ill to be removed. TABLE XII, (Diphtheria.) Date. Name of Vessel, Port of Registry, and Official Number. Where from. Number of cases. How dealt with. 1915. Jan. 16 s.s. "Delta," of Belfast, 120,709 Hongkong 1 Removed to Devonport Hospital. „ 20 Training Ship "Arethusa," lying off Greenhithe 1 Removed to Bow and Arrow Hospital. „ 25 H.M.T, " Royal Edward," lying off So uthend 1 Removed to Port Sanitary Hospital. 26 Training Ship " Arethusa," lying off Southend 1 Removed to Bow and Arrow Hospital. March 6 s.s. " Southend Belle," of London, 105,824. Lying at Royal Albert Dock. 1 Isolated on board. April 18 s.s. " Ballarat," of Greenock, 131,851 Sydney 1 Died, and body buried at sea. May 10 s.s. "Saxon," of London, 112,713 Lying at Tilbury Dock. 1 Allowed to proceed home. 15 s.s. " Royal Edward," of Toronto, 125,656. Lying off Southend. 1 Removed to Port Sanitary Hospital. Sept. 1 Training Ship "Exmouth," lying off Grays - 1 Removed to Eastern Hospital (M.A.B.). 21 Ditto ditto 1 Ditto. 7 Training Ship " Cornwall," lying off P urfleet 1 Removed to Wennington Hopital. Oct. 1 Training Ship " Exmouth," lying off G rays 1 Removed to Eastern Hospital (M.A.B.). Nov. 16 Ditto ditto Removed to Grove Hospital (M.A.B.). 4 s.s. Lady Olive," of Dublin, 132,838 Dublin 1 Removed to Port Sanitary Hospital. 29 Training Ship " Exmouth," lying off G rays - 1 Removed to South Eastern Hospital (M.A.B.). Dec. 17 Ditto ditto 2 Removed to Grove Hospital, Tooting. 18 21 TABLE XIII. (Enteric Fever.) Date. Name of Vessel, Port of Registry, and Official Number. Where from. No. of Cases. How dealt with. 1915. Jan. 11 s.s. " Huron," of London, 105,884 Bassein 1 Removal to hospital at Angiers. 11 5.s. " Prima " (Norwegian) Archangel 1 Removal to Seamen's Hospital, Greenwich. 28 s.s. "Malwa," of Glasgow, 127,543 Sydney 1 Landed at Plymouth. Feb. 3 s.s. " Bengali," of Liverpool, 113,454 - Calcutta 1 Landed at Suez. 10 s.s. " Borda," of Greenock, 136,340 - Brisbane 1 Died on board. „ 20 s.s. "Black Prince," of Newcastle, 114,437. English Channel 1 Removed to Seamen's Hospital, Greenwich. 25 s.s. " Hungarian Prince," of Newcastle, 111,307; Rosario 1 Landed at St. Vincent. 26 s.s. Pengreep," of Falmouth, 133,349 Saigon 1 Landed at Penang. „ 26 Training Ship " Cornwall," lying off Pu rfleet 1 Removed to Wennington Hospital. March 4 s.s.,l Esmeralda," of Liverpool, 123,985 Chili 1 Landed at Las Palmas. 5 s.s. "Brisbane River." of West Hartlepool Buenos Ayres Removed to Port Sanitary Hospital, 6 s.s. " Fushimi Maru" (Japanese) Yokohama 1 Removed lo Seamen's Hospital, Greenwich. >» ' C.T., No. 5 Sydney 1 Landed at Cape Town. 16 s.s. " Manors," of Glasgow, 133,129 - Calcutta 1 Landed at Aden. 17 s.s. "Norman," of Southampton, 104,042. Durban 1 Removed to Port Sanitary Hospital. v 24 s.s. "Ceramic," of Liverpool, 135,474- Australia 1 Landed at Avonmouth. „ 29 9.s. " Osterley," of Glasgow, 128,387 - Sydney 1 Removed to Port Sanitary Hospital. 30 Training Ship " Cornwall," lying off Pu rfleet Ditto. April 1 s.s. 11 Briton," of Southampton, 106,919 Durban 1 Ditto. ,, 1 Training Ship " Cornwall," lying off' Pu rfleet 1 Removed to ship's hospital on shore. ,, 7 s.s. 11 Poona," of Glasgow, 121,202 Sydney 1 Landed at Melbourne. ,, 8 s.s. " Swazi," of London, 114,734 Madras 1 Landed at Marseilles. ,, 13 s.s. "Nirvana," of Glasgow, 136,829 - Calcutta 1 Ditto. ,, 17 s.s. "Medina," of Greenock, 131,849 - Sydney 1 Allowed to proceed to a N ursing Home in London. ,, 17 Training Ship "Cornwall," lying off Pn rfleet 1 Removed to Port Sanitary Hospital. ,, 20 s.s. " Swazi, of London, 114,734 Madras 1 Landed at Marseilles. ,, 24 s.s. "Arabia," of Greenock, 105,587 - Bombay 1 Landed at Aden. ,, 28 Training Ship " Cornwall," lying off Pu rfleet 1 Removed to Port Sanitary Hospital. May 13 s.s. "Chantala," of Glasgow, 133,099 - Colombo 1 i Landed at Malta. June 3 s.s. "Algeria," of Anvers - Alexandria 1 Landed at Gibraltar. July 6 s.s. "Carnarvonshire," of Belfast, 132,049. Lying in Royal Albert Dock 1 Removed to Branch Seamen's Hospital, Royal Albert Dock. Forward 32 22 Date. Name of Vessel, Port of Registry, and Official Number. Where from. No. of Cases. How dealt with. 1915. Brought forward 32 July 26 s.s. "Berwick Castle," of London, 114,822. Zanzibar 10 1 case removed to Port Sanitary Hospital, 6 landed at Cape Town, 2 at St. Helena, and 1 at Ascension. 30 s.s. " Malatian," of Liverpool, 135,534 Alexandria 1 Landed at Marseilles. Aug. 3 s.s. " Rhea " (Russian) Valencia 1 Removed to Port Sanitary Hospital. 11 s.s. "Balmoral Castle," of London, 129,074. Durban 1 Landed at Plymouth. „ 24 s.s. "Highland Laddie," of London, 129,082. Buenos Ayres 1 Allowed to proceed home convalescent. Sept. 3 s.s. "Alnwick Castle, of London, 114,784 Mudros 1 Landed at Gibraltar. „ ' 7 s.s. "Malwa," of Greenock, 125,543 - Sydney 1 Remained on board. Convalescent. 13 s.s. " Ascania " 1 Removed to Port Sanitary Hospital. 21 s.s. ''Huntsend" (Prize Vessel) Mudros 1 Ditto. Oct, 4 s.s." SanDunstano,"of London, 132,743 Mexico Landed at Liverpool. 9 s.s. " Cluny Castle," of London, 128,371 Cape Town 1 case landed at Cape Town and 1 at Plymouth. „ 12 s.s. "Arachne," of West Hartlepool, 132,832. Montreal 1 Removed to Port Sanitary Hospital. 15 s.s. "Minnehaha," of Belfast, 110,520 New York 1 Ditto. 23 s.s. "Guildford Castle," of London, 132,611. — 1 Removed to Seamen's Hospital, Greenwich. Not. 12 s.s. "Iroquois, of Belfast, 124,667 Sabine 1 Removed to Port Sanitary Hospital. 12 s.s. "Walmer Castle," of London, 114,839. Natal Ditto, 1 case. 1 died and body buried at sea. Dec. 3 s.s. "Drake," of London, 125,677 Patras 1 Landed at Plymouth. 8 s.s. " Alcinous " — 1 Removed to Port Sanitary Hospital. 23 s.s. "Cape Ortegal," of Glasgow, 129,539. Mauritius 1 Died, and body landed at Mauritius. 29 s.s. "Medina," of Greenock, 131,849 Sydney 1 Removed to Seamen's Hospital, Greenwich. Total 64 TABLE XIV. (Measles.) Date. Name of Vessel, Port of Registry, and Official Number. Where from. No. of Cases. How dealt with. 1915. Feb. 10 s.s " Tagus," of London, 110,197 Colon 1 Landed at Trinidad. „ 16 s.s. " Persic," of Liverpool, 110,620. Sydney 1 Died on board. „ 16 s.s. " Ayrshire," of Glasgow, 119,066. Do. 1 Isolated on board. Mar. 5 s.s. " Llanstephan Castle," of London, 135,315. Durban 5 Two cases landed at Plymouth, three removed to Port Sanitary Hospital. Mar. 18 to April 13 Training Ship " Worcester," lying o if Greeenhithe 29 Removed to Ship's hospital on shore. Mar. 24 s.s. " Ceramic," of Liverpool, 135,474. Australia 1 Landed at Avonmouth. Forward 38 23 Date. Name of Vessel, Port of Registry, and Official Number. Where from. No. of Cases. How dealt with. 1915. Carried £o rward 38 Mar. 26 East India Dock, Main Entrance, Firemen's Quarters. 1 Isolated at home. April 16-22 Training Ship " Worcester," lyingo ff Greenhithe 14 Removed to Ship's hospital on shore. 9 East India Dock, Firemen's Quarters 2 Isolated at home. „ 13 s.s. "Kashgar," of Greenock, 128,654. Calcutta 1 Recovered. „ 22 s.s. "Runic," of Liverpool, 113,441 Sydney 2 Landed at Suez. May 1 s.s. "Forth," of Grangemouth, 90,902. 1 Removed to Seamen's hospital, Greenwich. ,, 4 s.s. " Shropshire," of London, 132,607. Sydney 16 Removed to Suez Military hospital. ,, 7 s.s. "Sicilian," of Glasgow, 111,225 St. Johns 3 Allowed to proceed home. ,, 8 s.s. "Kaisar-I-Hind," of Greenock, 128,653. Bombay 2 Removed to Port Sanitary hospital. ,, 8 Training Ship " Exmouth," lying off Grays 1 Ditto. „ 27 s.s. " Orontes," of Glasgow. 115,707. Brisbane 13 Landed at Plymouth. „ 28 s.s. " Citv of York," of Glasgow, 119,100. Calcutta 1 Allowed to proceed home. June 7 s.s. " Copenhagen," of Harwich, 123,935. Rotterdam 1 Removed to Port Sanitary hospital. „ 19 s.s. " Sicilian," of Glasgow, 111,225. Montreal 4 Allowed to proceed home. „ 25 Training Ship " Exmouth," lying off Grays 1 Removed to Ship's hospital on shore. July 14 s.s. " Turakina," of Plymouth, 114,620. Wellington 1 Landed at Plymouth. Aug. 6-11 Training Ship "Exmouth," lying off Grays 17 Removed to Homerton and Joyce Green hospitals. ,, 3 s.s. " Dover Castle," of London, 118,409. Cape Town 3 Removed to Port Sanitary Hospital. „ 25 s.s. "Orsova," of Glasgow, 128,278 Brisbane 105 1 removed to Port Sanitary Hospital. 104 landed at Plymouth. Sept. 7 s.s. " Malwa," of Greenock, 127,543. Sydney 1 Allowed to proceed home convalescent. Oct. 4 s.s. "Morea," of Glasgow, 128,235 Do. 8 7 cases landed at Port Said, and 1 left vessel in London convalescent. ,, 15 s.s." Omrah," of Glasgow, 108,782 Brisbane 8 Landed at Plymouth. „ 15 s.s. "Balmoral Castle,"of London, 129,074. Natal 4 Ditto. ,, 18 s.s. " Maloja," of Belfast, 132,012 Sydney 1 Landed at Port Said. „ 20 s.s. " Rotoruaof Plymouth, 124,587. Wellington 2 Landed at Plymouth. ,, 25 s.s. " Miltiades," of Aberdeen, 118,179. Sydney 12 Left vessel in London convalescent. Nov. 8 s.s. " Osterley," of Glasgow, 128,287. Brisbane 31 Landed at Suez. „ 17 s.s. " Moldavia," of Greenock, 117,382. Sydney 13 Landed at Aden. 22 55 s.s. "Corinthian," of Glasgow, 111,257. Montreal 20 Removed to Port Sanitary Hospital. „ 27 s.s. " Siciliau," of Glasgow, 111,225. Do. 2 Allowed to proceed home with parents. Dec. 11 s.s. "Arawa," of Southampton. 124,461. Wellington 6 2 cases removed to Port Sanitary Hospital. 4 recovered. „ 17 s.s. " Finland " (U.S.A.) New York 2 Left vessel in London, convalescent. Total 337 24 MEASLES. An outbreak of Measles occurred on the Nautical Training Ship " Worcester." Each case as it occurred was isolated, and the necessary measures of disinfection carried out, but with so many " susceptible " boys on board, who were not protected by a previous attack, a number of cases was certain to occur. MEASLES AND ENTERIC FEVER. The s.s. "Ceramic," of Liverpool, 135,474, arrived at Gravesend on the 4th March, from Australia. The master reported "no sickness" on arrival. On the 23rd March, information was received that cases of Measles and Enteric Fever were landed from this vessel at Avonmouth, the patients being soldiers. The owners were communicated with, stating that such sickness should have been reported on arrival at Gravesend. On the 30th March, they replied that, " 'We will have instructions issued that all cases of illness, no matter of what nature, must be declared on arrival at Gravesend." An explanation from the master as to why he did not report the cases was asked lor, and the master replied that, " On my arrival at Gravesend on the 4th March, I reported to the Customs when boarded, that we had Measles on board during the homeward voyage. The ship's doctor saw the port doctor at the same time, I understood that he had reported to the port doctor." The ship's surgeon also reported that no cases of dangerous infectious disease were landed at Avonmouth, only several cases of non-infectious disease under the direction of a military doctor. TABLE XV. (German Measles.) Date. Name of Vessel, Port of Registry, and Official Number. Where from. Number of Cases. How dealt with. 1915. Aug. 24 s.s. "Clan Macewen," of Glasgow, 133,053. Sydney 10 Landed at Suez. 10 TABLE XVI. (Erysipelas.) Date. Name of Vessel, Port of Registry, and Official Number. Where from. No. of Cases. How dealt with. 1915. Jan. 30 H.M.T. " Saxonia," lying off Southend - Removed to Port Sanitary Hospital. May 8 s.s. "Lady Londonderry," of Sunderland, 123,955. - 1 Removed to Seamen's Hospital, Greenwich. 8 Hopper No. 4 Barrow Deeps 1 Ditto. 17 No. 1 Customs and Excise Office, London Dock 1 Isolated at home. 20 s.s. " Tlieologos " (Greek) Alexandria 1 Removed to Wliitechapel Infirmary. July 15 s.s. "Corinthian," of Glasgow, 111,257 Montreali 1 Allowed to proceed home. Oct. 20 s.s. " Parisiana,'' of Liverpool, 127,465 Buenos Ay res 1 Isolated on board. Nov. 9 s.s. "Crimdon" (Sweden) Hernosanil 1 Ditto. Dec. 20 Training Ship "Exmouth," lying off Grays 1 Removed to Ship's Hospital on shore. Total 9 25 ERYSIPELAS. The s.s. " Crimdon " (Swedish), arrived at Gravesend on the 1st November, when the usual questions were put to the master, but his answers showed no illness on board. On arrival in dock, the boatswain was found to be ailing, and was subsequently notified as suffering from Erysipelas, and it would appear that the man had been ill for six or seven days before arrival at Gravesend. The patient was properly isolated on board. The master of the vessel was asked for an explanation of his failure to report this case, and he replied that in his opinion the man was suffering from the " effects of a bad cold," and as he was improving he did not think it serious enough to report. The man resumed work, apparently all right. In view of the master's explanation, further action was considered undesirable. TABLE XVII. (Continued Fever.) Date. Name of Vessel, Port of Registry, and Official Number. Where from. No. of Cases. How dealt with. 1915. March 31 s.s. "City of Madras," of Liverpool 118,015. Singapore 1 Landed at Marseilles. June 24 s.s. "Ascania," of Liverpool, 131,342- Alexandria 2 Removed to Port Sanitary Hospital. July 6 s.s. "Zeta," of London, 95,416 - Colon 1 Ditto. Oct. 14 s.s. "Kaisar-I-Hind," of Greenock, 128,653. Bombay 1 Landed at Aden. 27 s.s. "Pagenturm " (Interned German) Karachi 1 Removed to Port Sanitary Hospital. Dec. 7 s.s. "Alcinous," of London, 110,636 Manila 1 Ditto. Total 7 TABLE XVIII. (Pulmonary Tuberculosis.) Date. Name of Vessel, Port of Registry and Official Number. Where from. No. of Cases. How dealt with. 1915. Jan. 5 s.s. "Orsova," of Glasgow, 128,258 Brisbane 1 Landed at Plymouth. ,, 19 s.s. "Highland Corrie," of London, 129,117. Buenos Ayres 1 Allowed to proceed home. ,, 25 s.s. " Khiva," of Liverpool, 135,533 - Calcutta 1 Ditto. Feb. 2 s.s. " Italian," of London, 110,090 East London 1 Removed to Brompton Hospital. ,, 7 s.s. " Opawa," of Plymouth, 124,566 - Sydney 1 Allowed to proceed home. ,, 9 s.s. '' Plassy," of Glasgow, 109,259 - Liverpool 2 Isolated in P. & O. Co.'s Shore Quarters, Royal Albert Dock. ,, 15 March 1 s.s. " Scottish Monarch," of Glasgow, 124,125 s.s. "Clan Fraser,"of Glasgow, 111,259 St. John's Gal be 1 1 Allowed to proceed home. Landed at Malta. ,, 2 s.s. "Umvoti," of London, 105,857 - Hull 1 Removed to Seamen's Hospital, Greenwich. ,, 4 s.s. "Kaisar-I-Hind," of Greenock, 128,563. Bombay 1 Ditto. ,, 5 Training Ship " Cornwall," lying off Purfleet 1 Removed to Ship's hospital on shore. ,, 5 s.s. " Llanstephan Castle," of London, 135,315 Durban 2 Landed at Plymouth. Forward 14 26 Date. Name of Vessel, Port of Registry,.and Official Number. Where from. No. of Cases. How dealt with, 1915. Brought forward 14 March 9 s.s. " Mooltan," of Greenock, 117,497 - Sydney 1 Allowed to proceed home. ,, 10 s.s. "Nankin," of Greenock, 131,857 - Yokohama 1 Died, and body landed at Marseilles. ,, 12 s.s. "Dunvegan Castle," of London, 105,854. Durban Died, and body buried at sea. ,, 24 s.s. " Moldavia," of Greenock, 117,382 Sydney 1 Removed to Chatham Naval Hospital. April 9 s.s. " Braziliana," of West Hartlepool, 124,328. Busreh 1 Landed at Onn. ,, 9 s.«. " Clarissa Radcliffe," of London, 135,204. San Francisco 1 Landed at Falmouth. ,, 10 s.s. " Knight Companion," of Liverpool, 135,469. Bahia Blanca 1 Died, and body landed in London. ,, 10 s.s. "Kenilworth Castle," of London, 118,433. Cape Town 1 Landed at Plymouth. ,, 13 s.s. " Corinthic," of Liverpool, 115,296- Wellington 1 Allowed to proceed home. ,, 15 s.s. " Walmer Castle," of London, 114,839. Durban 1 Landed at Plymouth. ,, 21 s.s. " Saxon," of London, 112,713 Cape Town 1 Allowed to proceed home. „ 28 s.s. " Wakasa Maru " (Japanese) Kobi 1 Died, and body buried at sea. May 4 s.s. " Kildonan Castle," of London, 112,615. Durban 1 Landed at Plymouth. ,, 8 s.s. " Cedar Branch," of Sunderland, 123,970. .... 1 Removed to Seamen's Hospital, Greenwich. „ 14 s.s. "Dunvegan Castle," of London," 105,854. Natal 1 case landed at Plymouth. 1 allowed to proceed home. ,, 15 s.s. " Malwa," of Greenock, 127,543 Sydney 1 Allowed to proceed home. „ 22 s.s. " Llandovery Castle," of London, 135,302. Mombassa I Landed at Plymouth. „ 22 s.s. " Telamon," of Liverpool, 120,820- Brisbane 1 Allowed to proceed home. „ 29 s.s. ''Tiara," of Newcastle, 133,529 Durban 1 Do. ,, 29 s.s. "Llanstephan Castle," of London, 135,315. Do. Landed at Plymouth. June 6 s.s. '• Highland Corrie," of London, 129,117. Buenos Ayres- 1 Allowed to proceed home. ,, 11 s.s. "Briton," of Southampton, 106,919 Durban Died, and bodies buriedatsea. ,, 16 s.s. '' Nore," of Greenock, 123,531 Y okohama 1 Landed at Hong Kong. ,, 18 s.s. " Kenilworth Castle," of London, 118,433. Durban 1 Allowed to proceed home. ,, 19 s.s. "Sicilian," of Glasgow, 111,225 Montreal Died, and bodies buried at sea. „ 24 s.s. " Walmer Castle," of London, 114,839. Durban 1 Landed at Plymouth. ,, 30 s.s. " Durham Castle," of London, 118,387. Cape Town 1 Allowed to proceed home. July 5 s.s. " Zealandic," of Liverpool, 131,389 Auckland 2 Ditto. ,, 6 s.s. "Saxon," of London, 112,713 Durban 1 Lauded at Plymouth. ,, 8 s.s. " Glengyle," of London, 136,711 Seattle 1 Died, and body landed at Hong Kong. ,, 8 s.s. " Kildonan Castle," of London, 112,615. Durban 1 Allowed to proceed home. ,, 14 s.s. " Turakina," of Plymouth, 114,620 Wellington 1 Landed at Plymouth. ,, 15 s.s. "Corinthian," or Glasgow, 111,257 Montreal 1 Died, and body buried at sea. „ 15 s.s."Moldavia," of Greenock, 117."82 Sydney 1 Allowed to proceed home. „ 29 s.s. " Gaika." of Southampton, 106,908 Cape Town 2 Landed at Plymouth. Forward 56 27 Date. Name of Vessel, Port of Registry, and Official Number. Where from. No. of . Cases. How dealt with. 1915. Brought forward 56 Aug. 4 s.s. "Llandovery Castle," of London, 135,302. Durban 2 Landed at Plymouth. ,, 4 s.s. "Commonwealth," of London, 115,903. Sydney 1 Remained at work on board. ,, 9 s.s. "Chinkoa," of Glasgow, 128,943 - Karachi 3 2 cases landed at Aden ; 1 died, and body landed at Suez. ,, 9 s.s. "Llanstephan Castle," of London, 135,315. Cape Town 1 Landed at Plymouth. ,, 11 s.s. "Ceramic," of Liverpool, 135,474 - Sydney Removed to Devonport Hospital. ,, 11 s.s. "Balmoral Castle," of London, 129,074. Durban 1 Remained at work on board. ,, 14 s.s. "Hilda Lea" (Norwegian) - Africa 1 Removed to Seamen's Hospital, Greenwich. „ 19 s.s. " Toyama Maru" (Japanese) Yokohama 1 Remained at work on board. Sept. 4 s.s. "Walmer Castle," of London, 114,839. Natal 1 Landed at Plymouth. ,,, 5 s.s. " Pomeranian," of Glasgow, 85,193 Montreal 1 Allowed to proceed home. ,, 22 s.s. " Persia," of Greenock, 109,258 - Sydney 1 Remained on board at work. Oct. 11 s.s. " Explorer," of Liverpool, 131,295 Calcutta 1 Landed at Colombo. ,, 15 s.s. " Minnehaha," of Belfast, 110,520 New York 1 Left vessel in London. ,, 20 s.s. "Rotorua," of Plymouth, 124,587 Wellington 1 Died on board. ,, 27 s.s. " Salsette," of Greenock, 127,538 Bombay 1 Landed at Plymouth. Nov. 9 s.s. "Kenilworth Castle," of London, 118,433. Durban 1 Ditto. ,, 11 s.s. " Arzila," of Liverpool, 124,097 Morocco 1 Left vessel in London. ,, 17 s.s. "Moldavia," of Greenock, 117,392 Sydney 1 Ditto. „ 22 s.s. "Braemar Castle," of London, 108,381. 1 Removed to Poplar Hospital. Dec. 10 s.s. " Persia," of Greenock, 109,258 Bombay 1 Left vessel in London. ,, 16 s.s. "Highland Rover," of London, 129,067. Buenos Ayres 1 Died on board. „ 29 s.s. "Turakina," of Plymouth, 114,620 Auckland 1 Landed at Plymouth. ,, 29 s.s. "Balmoral Castle," of London, 129,074. Durban 3 Ditto. Total 85 PULMONARY TUBERCULOSIS. On arrival of the s.s. " Mooltan," of Greenock, 117,397, from Sydney, on the 8th March, 1915, the baker was found to be suffering from Pulmonary Tuberculosis. The patient left the vessel in Tilbury Dock, and his name and address were notified to the Medical Officer of Health concerned. The infected cabin was disinfected. The s.s. "Minnehaha," of Belfast, 110,520, arrived from New York on the 13th October. The ship's cook was found to be suffering with well marked symptoms of Pulmonary Tuberculosis, and he had made many voyages in the ship. The undesirability of a man suffering from marked symptoms of that disease, being engaged in the preparation of articles of food, is sufficiently obvious. 28 TABLE XIX. (Miners' Phthisis.) Date. Name of Vessel, Port of Registry, and Official Number. Where from. No. of Cases. How dealt with. 1914. Feb. 15 s.s. " Llandovery Castle," of London, 135,302. Mombasa l Landed at Plymouth. Mar. 13 s.s. " Dover Castle," of London, 118,409. Durban 1 Ditto. „ 24 s.s. " Balmoral Castle," of London, 129,074. Cape Town 2 Allowed to proceed home. Apl. 17 s.s. " Saxon," of London, 112,713 - Do. 3 Ditto. June 3 s.s. " Balmoral Castle," of London, 129,074. Durban 2 Landed at Plymouth. Nov. 27 s.s. "Saxon," of London, 112,713 - Do. 2 Left vessel in London. Total 11 TABLE XX. Tuberculosis (other than Pulmonary). Date. Name of Vessel, Port of Registry, and Official Number. Where from. No. of Cases. How dealt with. 1915. June 16 s.s. "Sebek," of Liverpool, 129,034. Port Sudan 1 Allowed to proceed home ,, 19 s.s. "Tagus," of London, 110,197. Colon 1 Ditto ,, 19 s.s. "Morvada," of Glasgow, 136,319. Calcutta 1 Ditto August 24 s.s. "Highland Laddie," of London, 129,082. Buenos Ayres 1 Ditto Sept, 23 s.s. "Corinthic," of Liverpool, 115,296. Wellington 1 Ditto Oct. 25 s.s. " Miltiades," of Aberdeen, 118,179. Sydney 1 Died on Board. Total 6 29 TABLE XXL (Chicken-Pox.) Date. Name of Vessel, Port of Registry, and Official Number. Where from. Number of Cases. How dealt with. 1915. Feb. 6 s.s. " Cambrian," of West Hartlepool, 106,957. Boston 1 Left vessel in London, convalescent. „ 16 s.s. " Arabia," of Greenock, 105,581, Bombay 1 Landed at Plymouth. March 4 s.s. " Lindenfels," of London, 136,788. Do. 1 Removed to Port Sanitary Hospital. „ 5 s.s. " Clan Alpine," of Glasgow, 111,232. Calcutta 1 Landed at Colombo. „ 16 Royal Albert Docks 1 Removed to Hospital at Woolwich. „ 29 s.s. '• City of Glasgow," of Glasgow, 121,304. Madras 3 1 case landed at Colombo. 2 cases isolated on board. April 2 s.s. " Malakand," of Liverpool, 120,907. Calcutta 1 Isolated on board. „ 13 s.s. "Clan Macaulay," of Glasgow, 108,800. Pt. de Galle 2 Landed at Aden. „ 21 s.s. " Malakand," of Liverpool, 120,907. Calcutta 2 Isolated on board. May 26 s.s. " Mandalay," of Glasgow, 108,755. Rangoon 1 Ditto. June 9 s.s. " Khiva," of Liverpool, 135,533. Calcutta 2 1 case landed at Madras, and 1 isolated on board. „ 11 Training Ship " Warspite," Greenhithe. lying off 1 Removed to ship's Hospital, on shore. July 23 s.s. " Marathon," of Aberdeen, 118,184. Brisbane 2 Landed at Plymouth. „ 30 s.s. " Minnewaska," of Belfast, 124,674. Alexandria 1 Allowed to proceed home, convalescent. Aug. 4 s.s. " Commonwealth," of London, 115,903. Sydney 5 Landed at Cape Town. „ 11 s.s. " Balmoral Castle," of London, 129,074. Durban 1 Landed at Plymouth. Nov. 20 s.s. " Umzumbi," of London, 118,392. Beria 4 Removed to Port Sanitary Hospital. „ 23 Training Ship "Warspite," lying off Greenhithe. 4 Removed to Ship's hospital on shore. „ 22 s.s. " Corinthian," of Glasgow, 111,257. Montreal 1 Ditto. „ 27 s.s. "Saxon," of London, 112,713 Durban 2 Landed at Plymouth. Total 37 CHICKEN-POX. On the 2nd March, information was received from the Branch Seamen's Hospital, Royal Albert Dock, that a Native there, from the "Lindenfels," of London, 136,788, was suffering from Chicken-pox, but that the disease was, however, suspicious of Smallpox. The patient was immediately removed to Denton Hospital for observation. The disease did not prove to be Small-pox, and the patient was discharged irom Hospital on the 6th March. The Lascars' quarters and effects were disinfected by this Authority. The vessel had been lying in the Royal Victoria Dock since the 11th January last, when it arrived from Bombay. On the 16th March, information was received from the Medical Officer of Health for Woolwich, respecting a case of Chicken-pox, which was, however, suspicious of Smallpox. The patient was a timekeeper for a firm in the Royal Albert Dock, and was seen by the Medical Officer of Health for Woolwich on the 12th March. Enquiries were made in the dock, but the source of infection could not be traced. 30 TABLE XXII. (Cerebro-Spinal Meningitis.) t Date. Name of Vessel, Port of Registry, and Official Number. Where from. No. of Cases, How dealt with. 1915. Feb. 25 Training Ship "Warspite," lying off Greenhithe. 2 Removed to Port Sanitary Hospital. April 23 Ditto ditto 1 Ditto June 21 Barge " Ebenezer " 1 Removed to Hospital at Sittingbourne. Oct. 4 s.s. " Morea," of Glasgow, 128,235 Sydney 1 Landed at Colombo. Total 5 TABLE XXIII. (Mumps.) Date. Name of Vessel, Port of Registry, and Official Number. Where from. No. of Cases. How dealt with. 1915. Jan. 29 Training Ship "Exmouth," lying off Purfleet. 1 Removed to Wennington Hospital. Oct. 25 Training Ship "Cornwall," lying off Grays. 3 Removed to Eastern Hospital (M.A.B.) Total 4 TABLE XXIV. (Blackwater Fever.) Date. Name of Vessel, Port of Registry, and Official Number. Where from. No of Cases. How dealt with. 1915. July 22 s.s. "Geelong," of London, 118,426 Sydney 1 Died, and body buried at sea. Aug. 3 s.s. "Magoya," of Greenock, 135,323 Yokohama 1 Landed at Suez. Total 2 TABLE XXV. (Beri-Beri.) Date of Arrival. Name of Vessel, Port of Registry, and Official Number. Where from. Number of Cases. 1915. February 7 s.s. " Kitano Maru " (Japanese) Japan 1 May 5 s.s. " Suwa Maru " (Japanese) Yokohama 2 ,, 14 s.s. "Yare," of London, 92,965 Trinidad 1 (fatal) July 5 s.s. " Arabia Bombay 1 August 3 s.s. ' Senegambia" Hong Kong 1 ,, 16 s.s. "Mentor Foochow 1 ,, 28 s.s. "Peleus" Shanghai 3 Sept. 30 s.s. "Homayum," of Bombay, 108,180 Bombay 1 (fatal) October 21 s.s. "Knight Companion,"f Liverpool, 135,469. Yokohama 1 (fatal) December 16 s.s. "Boeton" (Dutch) - Java 1 Total 13 31 Cases of Illness, &c., other than Dangerous Infectious Disorders reported on Incoming Vessels during 1915. Accident 2 Brought forward 98 Adenitis 2 Heat Apoplexy 2 Abdominal Tumour 1 Hernia 1 Appendicitis 4 Influenza 5 Aneurysm of Aorta 1 Injury to Spinal Cord 1 Alcoholic Poisoning 2 Infantile Convulsions 1 Asthma 1 Inanition 1 Bleeding from Stomach 1 Intestinal Obstruction 1 Broncho-Pneumonia 2 Java Fever 1 Bronchitis 3 Kidney Disease 1 Bright's Disease 1 Lobar Pneumonia 3 Broken Neck 1 Laryngitis 1 Cancer 4 Malaria 11 "Cold" 2 Morbus Cordis 1 Cellulitis 3 Mucous Colitis 1 Catarrh 1 Meningitis 1 Congenital Meningitis 1 Mediterranean Fever 1 Cut Throat 1 Malarial Fever 2 Cerebral Haemorrhage 2 Mumps 2 Colitis 1 Nephritis 3 Chill 1 Neurasthenia 1 Constipation 1 Pneumonia 10 Colic 2 Pleurisy 8 Cerebral Apoplexy 1 Poisoned Foot 1 Dropsy 1 Paralytic Dementia 1 Dysentery 12 Paraplegia 3 Diabetic Eclampsia 1 Parotid Abscess 1 Diabetes 1 Paratyphoid 1 Dengue 1 Peiitonitis 1 Diarrhoea 1 Quinsy 1 Enteritis 4 Rheumatism 4 Fatty Heart 1 Suicide 2 Fibrositis 1 Sore Throat 1 Gastritis 1 Senile Decay 1 Gastric Ulcer 2 Stomatitis 1 Gonorrhceal Rheumatism ] Syphilis 5 G astro-Enteritis 2 Swollen Knee 1 Heart Disease 18 Tonsilitis 1 Headache 1 Vomiting 1 Hepatitis 2 Venereal Disease 5 Heat Exhaustion 2 —- Heat Stroke 5 Total 188 Carried forward 98 NOTIFICATION OF INFECTIOUS DISEASE. It being desirable that Chicken-pox, Cerebro-spinal Fever (Epidemic Cerebrospinal Meningitis) and Acute Polio-myelitis or Acute Polio-encephalitis should be added to the list of diseases notifiable under Section 56 of the Public Health (London) Act, 1891, and that the additions should be permanent, steps were accordingly taken to obtain the consent of the Local Government Board to this course. This was granted, and the required public notice will be duly published. 32 TABLE XXYI. HOSPITAL. Number of Cases Admitted, Cost of Maintenance, &c. Patients remaining in Hospital on 31st December, 1914 9 Admitted. Discharged, Died Remaining ider treatment. Cholera 0 0 0 0 Cholera (suspected) 0 0 0 0 Plagu 0 0 0 0 Ditto (suspected) 0 0 0 0 Small-pox 10 8 2 0 Scarlet Fever 10 10 0 0 Enteric Fever 17 18 2 1 Continued Fever 5 5 0 0 Diphtheria 3 3 0 0 Measles 33 33 0 0 Erysipelas 1 1 0 0 Chicken-pox 6 11 0 0 Cerebro-spinal Fever 3 3 0 0 Other Diseases 2 2 0 0 Totals 90 94 4 1 Remaining in Hospital on 31st December, 1915 1 Total number of days treatment during the year 1,545 Average number of days treatment for each case15.16 Average daily number of patients in Hospital 3.68 Average daily cost of maintenance per patient 1s. 8.8d. Average total cost of maintenance per patient £1 7s. 2d. SHELL-FISH. The Local Government Board have issued Public Health (Shell-fish) Regulations, 1915, which came into force on the 1st March, 1915. These Regulations require the Port of London Sanitary Authority to take action on receipt of representation from a Local Authority in whose district shell-fish are consumed, indicating that the shell-fish have caused or are likely to cause infectious or other disease ; or on a report of their own Medical Officer of Health, if such shell-fish are found in their own district. 33 Such action means, in the case of public layings, that the Port of London Sanitary Authority shall give to the persons interested, notice to appear before them within such time, not less than 21 days, as may be specified in the notice, to show cause why an order should not be made prohibiting, as the circumstances may require, the distribution for sale for human consumption of shell-fish brought from the layings, unless the shell-fish have been relaid for such period as the Local Authority may direct—say not less than 14 days. This notice is to be given by advertisement, and a copy of the notice shall be served either personally or by post, upon every person known to be interested in the laying referred to in the notice. In the case of private layings, the Port of London Sanitary Authority shall communicate with the owner or occupier thereof, and if the owner or occupier is able and willing to give an undertaking that he will forthwith carry out the requirements for dealing with the shell-fish, the Port of London Sanitary Authority may accept the undertaking so given. If the undertaking is not given, the Port of London Sanitary Authority shall forthwith make such order as the circumstances require. If the Port of London Sanitary Authority on receipt of such representation, fail to give notice or to communicate with the owner, or if they shall refuse to make an order, then the Local Authority making the representation may appeal to the Local Government Board within 14 days, and the Local Government Board may make such inquiry into the circumstances as they may deem necessary, and if they are satisfied that an order should be made, they may require the Port of London Sanitary Authority to make such order as they think fit. The Port of London Sanitary Authority shall inform the Local Government Board and the Board of Agriculture and Fisheries of any action taken under these Regulations. Where an order has been made by the Port of London Sanitary Authority under these Regulations, and has come into operation, any person who for human consumption sells, or exposes, distributes, or offers for sale, or has in his possession for the purposes of sale, contrary to the order, shell-fish brought from the laying shall be deemed to be acting in contravention of these Regulations. Any of the persons interested may appeal to the Local Government Board against an order, and the Local Government Board may appoint an officer to hear their appeal, and report to them, and may confirm, vary or withdraw the order. The Local Government Board advise that any action taken with a view to the closing of a laying should be based on epidemiological and topographical considerations rather than on the result of bacteriological analysis. There are " layings " situated in the vicinity of Southend—the River Roach, Swale, Sheerness, Stangate Creek, &c., which will be inspected in due course. Notice.—The Public Health Act, 1896, provides by sub-section (3) of Section 1, that if any person wilfully neglects or refuses to obey or carry out, or obstructs the execution of, any regulation made under any of the enactments mentioned in that Act he shall be liable to a penalty not exceeding one hundred pounds, and in the case of a continuing offence to a further penalty not exceeding fifty pounds for every day during which the offence continues. 34 TABLE XXVII. Quantity and Description of Unsound Food Seized and Destroyed for the Year ending 31st December, 1915. Original packages. Sundry quantities by weight. Loose Articles. Approximate Total weight of Goods destroyed. MEAT— No. Description. Tons. cwts. qrs. lbs. No. Description. Tons. cwts. qrs. lbs. Fresh and Frozen— Beef 3903 quarters and crops 12 5 2 14 257 pieces 294 18 2 20 Mutton and Lamb 2,897 carcases ... 3 2 11 369 pieces 64 2 1 15 Veal, Pork and Offal 4,620 various ... ... ... ... 6,412 pieces 71 8 2 2 Preserved— Tinned 186 cases ... ... ... ... 588 tins 6 3 0 15 Smoked and Salted 272 casks, &c. ... ... ... ... 902 pieces 17 2 0 2 Sundry ... ... ... ... ... ... ... ... ... ... ... RABBITS— Frozen 449 crates ... ... ... ... 29 rabbits 11 11 2 5 Tinned ... ... ... ... ... ... 16 tins ... ... 1 0 POULTRY and GAME— Frozen 93 cases, &c. ... ... ... ... 67 various 6 1 3 4 FISH— Preserved, Dried 5 boxes ... ... ... ... ... ... ... ... ... „ Tinned and Bottled 156 cases ... ... ... ... 1,002 tins, &c. 3 7 3 6 Shell 5 barrels ... ... ... ... ... ... ... 8 3 0 Wet 21 cases ... ... ... ... ... ... ... 7 2 26 FRUIT— Fresh 10,119 various ... ... ... ... ... ... 309 8 2 4 Preserved, Dried 3,621 various ... ... ... ... ... ... 87 12 2 14 „ Tinned and Bottled 115 cases 12 0 0 0 503 tins, &c. 17 15 0 27 „ Jam and Marmalade 989 cases ... ... ... ... 4 jars, &c. 29 11 3 21 VEGETABLES— Fresh 1,902 bags, &c. 188 14 1 17 ... ... 282 6 0 21 Preserved, Dried 589 bags, &c. ... ... ... ... 67 tins, &c. 50 7 0 0 NUTS Whole 6 bags, &c. ... ... ... ... ... ... ... 3 3 17 Desiccated 481 bags, &c. ... ... ... ... ... ... 25 1 1 1 PROVISIONS— Tea 2,917 chests, 4c. ... ... ... ... ... 174 4 4 8 Coffee 113 bags 50 0 0 0 ... ... 56 18 2 2 Cocoa 162 bags, &c. . . . ... ... ... 19 tins 15 9 3 19 Butter, Cheese, Lard, Margarine 90 boxes, &c. 1 4 0 5 ... ... 2 5 0 16 Condensed Milk 8,376 cases ... ... ... ... 1,850 tins 179 16 0 24 Prepared Foods 470 cases . . ... ... ... 3 tins, &c. 2 10 0 3 Biscuits and Confectionery 123 cases ... ... ... ... 41 tins 20 9 3 9 Sugar ... ... ... ... ... ... 1 bottle ... ... ... 4 GRAIN— Wheat, Maize, Barley, Rice, Ac. ... ... 1189 4 1 17 ... ... 1,189 4 1 17 MEAL and FLOUR 5 bags ... ... ... ... 2 tins ... 5 0 2 CONDIMENTS and SPICES - 186 bags, &e. ... ... ... ... 25 bottles,&c. 16 15 0 17 EGGS 2,320 cases ... ... ... ... ... ... 172 3 3 25 EGG YOLK - 5 cases ... ... ... ... ... ... ... 3 3 0 SUNDRIES 66 bales, &c. ... ... ... ... 54 tins, &c. 9 19 2 9 Total 45,262 various 1453 12 0 8 12,211 various 3,118 5 3 19 Approximate Total weight of Goods destroyed during the year 1909 1,415 7 0 22 1910 2,483 6 2 13 1911 1,408 4 3 1 1912 3,758 7 1 2 1913 2,458 0 2 21 1914 1,184 11 1 1 1915 3,118 5 3 19 35 TABLE XXYIII. Description oe Meat Destroyed. Year. Beef. Mutton. Veal, Pork, Offal. Tinned. Smoked and Salted, &c. Total. Tons cwts. qrs. lbs. Tons cwts qrs lbs. Tons cwts. qr s. lbs. Tons cwts. qrs. lbs. Tons cwts qrs lbs. Tons cwts. qrs. lbs. 1906 136 5 3 24 94 15 0 8 22 7 0 10 9 0 0 26 0 0 3 14 262 9 0 26 1907 47 5 2 16 63 6 2 24 8 11 1 6 2 14 4 5 63 8 0 22 185 6 3 17 1908 47 14 2 6 22 12 2 10 1 3 0 8 3 12 2 8 2 19 1 13 78 2 0 17 1909 19 11 3 7 21 3 1 17 Pork and Veal— 2 10 2 19 0 2 3 22 113 9 1 19 4 15 3 23 Offal— 65 4 2 15 1910 1,100 0 0 4 27 t 50 8 1 13 Pork and Veal— 3 2 2 2 32 13 1 6 1,234 1 3 24 3 5 0 13 Offal— 44 12 X iy 1911 341 6 • 3 18 25 A 9 1 6 Pork and Veal— 6 8 2 5 3 18 2 0 462 11 0 0 4 8 1 19 Offal— 80 . 19 . 1 8 1912 58 3 0 3 14 3 2 3 Pork and Veal— 5 17 3 17 3 2 2 16 108 11 3 6 7 14 2 13 Offal— 19 10 0 10 1913 31 13 0 18 134 5 3 14 Pork and Veal— 1 14 3 22 14 14 3 6 252 8 1 20 0 16 1 2 Offal— 69 3 1 14 Pork and Veal— 3 8 0 13 1 19 0 3 316 13 0 24 1914 82 9 3 26 161 11 1 22 11 6 1 27 Offal— 55 18 0 17 1915 294 18 2 20 64 2 1 15 Pork and Veal— 6 3 0 15 17 2 0 2 453 14 2 26 13 7 0 27 Offal— 58 1 1 3 Total for ten years 2,159 9 3 25 651 18 2 20 471 4 3 10 44 13 2 20 140 1 2 20 3,467 8 3 11 86 FOOD INSPECTION. The carrying out of the Regulations issued by the Local Government Board, under the Public Health (Regulations as to Food) Act, 1907, in the Port of London has this year resulted in the seizure by your Officers of 3,118 tons 5 cwts. 3 qrs. 19 lbs. of Unsound Food, which have been destroyed or disposed of in such a manner as to prevent its being used for human consumption. On one occasion this quantity has been exceeded. A summary of the Unsound Food seized is shown by Table XXVII. In no instance was it necessary to apply for a magistrate's order for the destruction of Unsound Food seized by your Officers. The total receipts of all kinds of frozen and chilled meats into the United Kingdom in 1915 amounted to 664,508 tons, as against 694,427 tons in 1914, and 720,257 tons in 1913. The world's export output of frozen and chilled beef, mutton and lamb in 1915 is estimated at 882,658 tons, compared with 800,413 tons in 1914. BEEF. The total arrivals of frozen and chilled beef was 5,632,105 quarters, compared Avith|5,788,147 quarters in 1914, being a decrease of 156,042 quarters. Australia contributed 1,143,779 frozen quarters. New Zealand „ 482,232 „ South America „ 2,228,493 „ ,, ,, ,, 1,162,898 chilled „ Other countries „ 258,761 frozen „ ,, ,, ,, 355,942 chilled „ Total 5,632,105 quarters. The number of quarters discharged from vessels in the Port of London was :— From Australia 697,664 frozen quarters. ,, New Zealand 457,759 „ ,, „ South America 419,104 „ ,, ,, ,, ,, 1,009,411 chilled ,, „ other countries 152,669 frozen „ ,, ,, ,, 55,552 chilled ,, Total 2,792,159 quarters. This was an increase of 365,654 quarters and represented 49'57 per cent, (compared with 41*92 per cent, in 1914) of the total quantity imported into the United Kingdom. The quantity seized by your officers and destroyed as unfit for human food was 294 tons 18 cwts. 2 qrs. 20 lbs., and comprised 3,903 quarters and crops, 257 pieces and sundry bags and trimmings. The largest quantity seized on any ship was 2,296 quarters, weighing 185 tons 9 cwts. 0 qrs. 27 lbs. on a vessel which arrived in the Port in a damaged condition. 3 7 AUSTRALIAN BEEF AFFECTED WITH "WORM" (ONCHOCERCA). No beef affected with "Worm" (Onchocerca) came under the notice of your officers during the year. ACTINOMYCOSIS IN OX-TONGUES. With reference to the above subject referred to in the Annual Report for 1913 and 1914, only a very small proportion of the Ox-tongues which arrived in the Port of London during the year 1915 were examined by vour Officers. The remainder were, at the request of the consignees, allowed to leave the district of the Port of London Sanitary Authority (without inspection) for removal to cold stores with the City of London, the Metropolitan Boroughs of Bermondsey and Finsbury and the City of Liverpool, to be examined there under the supervision of the Medical Officers of Health of those districts. Seven consignments from Argentina were examined by your Officers and showed 1.25, nil (2), 1.15, .4, .39, .79 per cent, respectively affected with Actinomycosis. The examination of one consignment from Montevideo showed .83 per cent, of affected tongues, and of two consignments from Griqualand 1.4 and .63 per cent, affected. MUTTON AND LAMB. The total importations of frozen Mutton and Lamb into the United Kingdom during 1915 amounted to 12,191,361 carcases. From Australia - 3,582,911 carcases. „ New Zealand 6,494,197 „ ,, South America 1,450,526 „ ,, United States 2,550 „ „ China 107 „ Total - 12,191,361 carcases. This was a decrease of 597,478 carcases, or 4.7 per cent, on the total for 1914. The total number of carcases discharged from vessels in the Port of London was :— From Australia 1,413,183 carcases. ,, New Zealand 6,146,615 „ ,, South America 976,092 „ ,, China .... 107 Total - 8,535,997 carcases. This was an increase of 39,262 carcases, and represented 70.01 per cent, (compared with 6643 per cent, in 1914) of the total quantity imported into the United Kingdom. The quantity seized by your Officers and destroyed as unfit for human food was 64 tons 2 cwts. 1 qr. 15 lbs,, and comprised 2,897 carcases, 369 pieces and sundry trimmings. The largest individual seizure was 938 carcases, weighing 23 tons 9 cwts., on a vessel which arrived in the port in a damaged condition. 38 PORK. The pork seized and destroyed was 277 carcases, 186 heads and 7 pieces. The seizures were made for the following reasons :— From. Tuberculosis. Putrid. Carcases. Heads. Carcases. Pieces. Australia ... ... 8 ... New Zealand 1 ... ... ... Canada 13 • • • 10 3 United States 12 4 1 0 Argentina 195 133 26 4 Holland 5 ... • • • ... China 6 49 ... ... Totals 232 186 45 7 With regard to the heads destroyed, these were removed from carcases found to be affected with tuberculosis, and Notices were served upon the consignees requiring the exportation of the carcases from which the heads had been removed. To the date of closing of this Report 25 of the carcases have been exported. OFFAL. The offal seized and destroyed comprised :— Tons. Cwts. Qrs. Lbs. Livers, Ox and Calf—253 cases, 3,981 loose 26 3 1 14 ,, Sheep and Lamb—11 cases, 36 crates, 1,768 loose 1 11 2 27 Kidneys —322 cases, 4 bags, 2,460 boxes, 6 loose 12 1 2 2 Sweetbreads —26 cases, 5 bags 0 5 0 16 Hearts, —102 bags, 54 loose 3 8 2 21 Plucks (Sheep and Lamb)—46 cases, 130 crates, 309 loose 2 12 2 0 Tongues, Ox—29 bags, 76 loose 1 0 0 6 Cheeks, „ —43 bags .... 1 8 0 27 Tripe —433 boxes, 3 bags 3 8 1 11 Tails, Ox—5 cases, 24 bags, 88 crates, 11 loose 3 14 1 17 Heads, Sheep—14 loose 0 0 1 0 Skirts, Ox —49 bags 1 1 3 13 Sundries —6 boxes, 5 bags, 19 baskets 1 5 0 17 Total weight 58 1 1 3 39 TINNED MEATS. The tinned meats seized and destroyed comprised:— Tons. Cwts. Qrs. Lbs. Beef—169 cases, 428 tins 5 16 0 13 Mutton—1 ease, 153 tins 0 3 1 0 Ham and Bacon—13 cases, 2 tins 0 10 2 20 Sausage Meat—3 cases 0 3 0 0 Sundries—5 tins 0 0 0 10 Total weight - 6 13 0 15 SMOKED AND SALTED. This class of meat, destroyed as unsound, consisted of :— Tons. Cwts. Qrs. Lbs. Bacon—1 half-side 0 0 0 27 Hams—1 case, 901 loose hams 2 15 2 14 Salt beef—11 casks 1 5 1 21 Salt pork—260 casks 13 0 2 24 Total weight 17 2 0 2 RABBITS (Frozen). Although there were only eight seizures of this class of goods during the year, the total quantity seized and destroyed, namely, 449 crates and 29 loose rabbits, weighing 11 tons 11 cwts. 2 qrs. 5 lbs. was a considerable increase upon recent years. RABBITS (Tinned), Only one seizure consisting of 16 tins, weighing 28 lbs. was made during the year. These goods had been rejected by the owners, and were seized by the Port Sanitary Authority to prevent sale to small buyers. POULTRY AND GAME. The total quantity of this class of goods seized and destroyed was 6 tons 1 cwt. 3 cjrs. 4 lbs., and comprised 31 crates turkeys, 26 ducks, 8 geese, 33 fowls, and 59 cases and 3 bags of sundries. 40 FISH. The fish of all kinds seized and destroyed totalled only 4 tons 4 cwts. 3 qrs 18 lbs., compared with upwards of 22 tons in the previous year, and included :— Tons. Cwts. Qrs. Lbs. Wet—21 cases 0 7 2 26 Dried—5 cases of Bloaters 0 0 2 14 Shell—5 barrels of Oysters 0 8 3 0 Tinned—Crayfish, 77 cases 2 4 2 8 „ Herrings 21 tins 0 0 0 21 ,, Lobster 70 tins 0 0 2 2 „ Oysters 15 tins 0 0 0 7 ,, Salmon 1 case, 737 tins 0 5 1 13 „ Sardines 56 tins 0 0 1 0 „ Shrimps 33 cases, 23 tins 0 14 1 11 ,, Sundries 45 cases, 80 tins 0 2 2 0 Total weight 4 4 3 18 FRUIT (Green). The goods seized under this heading show an increase of upwards of 168 tons, compared with the previous year, and comprised :— Tons. Cwts. Qrs. Lbs. Apples—98 barrels, 689 boxes 22 9 2 15 Bananas—4,571 crates, 10 bundles 118 11 0 0 Grapes—8 boxes 0 2 o o 5 Lemons—2 cases 0 0 2 0 Mangoes—11 barrels, 6 cases 0 13 2 18 Melons—1 barrel, 5 crates, 17 cases 1 14 0 0 Pears—8 barrels, 379 cases, 905 boxes 36 11 1 21 Pineapples—63 barrels, 166 cases 10 9 1 4 Oranges—2 barrels, 2,548 cases 98 15 0 11 Tomatoes—75 crates, 168 bundles, 181 boxes 19 7 1 10 Sundries—8 barrels, 18 cases 0 13 3 14 Total weight 309 8 2 4 FRUIT (Dried). The total quantity of this class of goods seized and destroyed was 87 tons 12 cwts. 2 qrs. 14 lbs., made up as follows :— Tons. Cwts. Qrs. Lbs. Currants—1,287 cases, 20 bags 36 15 0 0 Dates—1,034 boxes, 66 cases 33 9 0 21 Figs—124 cases, 11 bags, 656 mats, 78 taps, 11 serons 14 2 1 3 Plums—216 cases 0 14 O o 2 Raisins—33 bags 1 13 0 0 Sundries—63 boxes, 1 case, 21 bags 0 18 1 16 Total weight 87 12 2 14 As in previous years the Dates proved to be of commercial value for the manufacture of vinegar, and they were accordingly released for that purpose, the Medical Officer of Health of the districts to which the goods were proceeding being notified of the facts. 41 FRUIT (Tinned and Bottled). Under this heading are included:— Tons. Cwts. Qrs. Lbs. Apples—2 tins 0 0 0 2 Apricot pulp—8 cases 0 7 0 16 Cherries—100 cases 4 6 2 12 Prunes—1 tin 0 0 0 1 Raspberry pulp—6 cases 0 5 0 20 Strawberry pulp—30 tins 0 8 0 2 Sultanas—1 tin 0 0 0 2 Various—1 case, 469 tins, 240 cwts. by weight 12 8 1 0 Total weight 17 15 0 27 FRUIT, PRESERVED (Jam and Marmalade). Nine hundred and eighty-nine cases and four jars, &c., of jam and marmalade, weighing 29 tons 11 cwts. 3 qrs. 21 lbs., were seized and destroyed. VEGETABLES. Fresh— Tons. Cwts. Qrs. Lbs. Asparagus—21 crates 0 1 3 4 Cucumbers—2 boxes 0 1 0 0 Onions—1,819 bags, 50 baskets, 10 boxes, 1,964 cwts., 1 qr., 17 lbs. loose 192 3 1 17 Potatoes—Loose 90 0 0 0 Dried— Peas—560 sacks, 13 barrels 48 3 2 15 Tinned, &c.— Peas—13 cases 0 11 3 9 Spinach—45 tins 0 0 3 6 Pickles—22 bottles 0 0 0 14 Sundries—3 cases 0 1 2 12 Total weight 331 1 0 21 NUTS. Under this heading are included walnuts, pea-nuts and desiccated cocoanut, the total weight of the goods destroyed amounting to 25 tons 5 cwts. 0 qrs. 18 lbs. Most of these goods were utilised, under suitable guarantees, for oil extraction and cattle food. 42 PROVISIONS. The greater part of the tea and cocoa included in the following list were damaged as a result of vessels being sunk and on fire. Some of the goods proved to be of commercial value, for instance :— 157 tons 15 cwts. 4 qrs. 8 lbs. of tea were used for the extraction of caffeine, the margarine was used for soap making, and 169 tons 14 cwts. 2 qrs. 8 lbs. of condensed milk for confectionery purposes. The goods were only allowed to leave the district of the Port Sanitary Authority after your Medical Officer of Health had received satisfactory guarantees respecting them, and the Medical Officers of Health of the districts to which the goods were taken were furnished with full particulars. Tons. Cwts. Qrs. Lbs. Tea—2,565 chests, 327 bags, 22 tubs, 3 baskets 174 4 4 8 Coffee—113 bags, 50 tons loose 56 18 2 2 Cocoa—150 bags, 12 cases, 19 tins 15 9 3 19 Cheese—2 boxes, sundry trimmings, and 8 cases tinned 1 8 0 0 Margarine—80 boxes 0 17 0 16 Sugar—1 bottle 0 0 0 4 Condensed Milk—8,376 cases, 1,850 loose tins 179 16 0 24 Sundries 2 14 1 26 Total weight 431 9 1 15 BISCUITS AND CONFECTIONERY. With the exception of six cases of confectionery, weighing 9 cwts. 1 qr. 14 lbs., the goods under this heading were seized on a vessel which had been on tire :— Tons. Cwts. Qrs. Lbs. Biscuits—91 cases, 40 tins 16 18 3 21 Confectionery—32 cases, 1 tin 3 10 3 16 Total weight 20 9 3 9 43 GRAIN. Most of the grain seized as unfit for human food was subsequently released, under guarantees, for poultry or animal food, and notifications were sent to the Medical Officers of Health uf the districts to which it was being taken :— The total nuantitv dealt with was :— Tons. Cwts. Qrs. Lbs, Wheat 689 19 3 3 Maize 81 17 3 18 Barley 5 12 2 24 Oats 404 9 0 14 Rice 7 4 3 14 Total weight 1,189 4 1 17 MEAL AND FLOUR. Only 5 cwts. 0 qrs. 2 lbs. of this class of goods was seized and destroyed. CONDIMENTS AND SPICES. The whole of the goods under this heading were damaged by fire and water. They comprised :— Mustard, salt, peppercorns, spice and sauces, the total weight being 16 tons 15 cwts. 0 qrs. 17 lbs. EGGS. Of the 2,320 cases of eggs seized and destroyed, 1,994 cases came from one vessel. The total weight was about 172 tons 3 cwts. 3 qrs. 25 lbs. In addition there were five cases of egg yolk seized and destroyed, the weight being about 3 cwts. 3 qrs. 9 lbs. DRUGS. Only one seizure was made of goods under this heading, namely, 59 bales of senna, weighing 8 tons 17 cwts. SUNDRIES. Included under this heading are :— Cwts. Qrs. Lbs. Arrowroot—1 barrel 2 0 0 Hops—5 bales 16 0 0 Yeast—1 box 0 0 14 Total weight 18 0 14 44 TABLE XXIX. PUBLIC HEALTH (FOREIGN MEAT) REGULATIONS, 1908. During the year Notices were served under Articles III. (5). IV. (1) and VI. of the above-mentioned Regulations, for the exportation of the following meat :— Date of Arrival. Name of Vessel. Where from. Where lying. Description and quantity of meat in respect of which Notices were served. 1915. Jan. 3 s.s. " Highland Glen" Argentina Royal Albert Dock 9 pig-carcases. „ 13 s.s. " Highland Scot" Do. Do. 5 pig-carcases. „ 18 s.s. " Highland Corrie Do. Do. 1 pig-carcase. Mar. 3 Nov. 2 s.s. " Brodstone " s.s. " Highland Laddie Hankow Argentina - Surrey Commercial Dock Royal Albert Dock 48 cases pig-tongues. 17 pig-carcases. „ 8 s.s. " Highland Loch " Do. Do. 17 pig-carcases. „ 11 s.s. " Brodmore " Nankin Royal Victoria Dock 49 pig-carcases. ,, 22 s.s. " Highland Glen " Argentina Royal Albert Dock 37 pig-carcases. Dec. 4 s.s. " Highland Piper " Do. Do. 36 pig-carcases. „ 7 s.s. " Anglian " Boston Do. 19 pig-carcases. „ 13 s.s. " Highland Rover " Argentina Do. 13 pig-carcases. „ 20 s.s. " Highland Loch " Do. Do. 27 pig-carcases. 45 TABLE XXX. General Summary, and Analysis, of the Sanitary Inspections of Vessels, &c., in the Port of London, for the year ended 31st December, 1915. Foreign. Coastwise. Inland Navigation. Shore Premises. Sick Seamen referred to Hospital. Water Barges. Steam. Sail. Steam. Sail. Steam. Sail. Lighters (uninhabited). Canal Boats. Inspected. Defective. To be Cleaned. Inspected. Defective. To be Cleaned. Inspected. Defective. To be Cleaned. Inspected. Defective. To be Cleaned. Inspected. Defective. To be Cleaned. Inspected. Defective. To be Cleaned. Inspected. Defective. ' To be Cleaned. Inspected. Defective. To be Cleaned. Inspected. Defective. To be Cleaned. No. in District in good condition, 31st December, 1915. New Barges Condemned. | Use Discontinued. No. in District Slat December, 1915. , 12042 145 1307 430 3 30 2194 20 170 979 12 46 717 5 48 11611 81 346 1685 7 176 420 46 17 4631 64 694 6 — - - 15 Total Inspections to 31st December, 1914 - - 1,100,830 Docks and River. No. Nationality. Arrived from Foreign Ports. No. of inspections Arrivals Percent of Total. St. Katharine's 855 American - 31 53 •43 Total Inspections from 1st January to 31st December, 1915 — London - 2,230 Argentine - 1 - •01 Austrian - - - " Foreign " - 12,472 Regent's Canal 647 Belgian 192 373 2.68 Brazilian 3 "Coastwise" - 3,173 Millwall 1,699 British 4,212 8,044 58.81 " Inland West India 1,903 Chilian - gation " - 14,433 Danish 181 288 2.52 Premises on Poplar 214 Dutch 814 967 11.36 shore 4,631 34.709 East India 736 Finnish 5 16 •06 French 250 333 3.49 Total 1,135,539 Victoria 2,738 German (ex) 9 1 •12 Royal Albert 2,432 Greek 47 145 •65 Cleansing of Crew's Quarters, &c. :— Italian 8 18 •11 Commercial 3,680 Japanese 50 188 •69 Total to 31st December, 1914 72,595 Tilbury - 1,604 Mexican — — — Portuguese 2 1 •02 lotal No. of Vessels from 1st January to 31st December, 1915 - 2,140 Gravesend District — Roumanian — — River—* Upper District 4,359 Russian 65 95 •90 Siamese — — — Total 74,735 "Middle „ 3,025 Spanish 90 136 1.25 Uruguayan - — __ Number of vessels inspected :— *Lower „ 3,956 Swedish & Norwegian 1,204 1,811 16.81 In the Launches— Medway Nil. " Lady Truscott" 808 30 078 Total vessels 7,161 12,472 " David Burnett ' 3,148 Coastwise and Inland navigation 17,606 " George Briggs " Total 7,384 Shore premises 4,631 Shore premises 4,631 11,340 Total 34,709 Total 34,709 99.91 In the Docks, &c. 18,738 *Upper District extends from Greenwich to Teddington. *Middle „ „ „ Greenwich to Erith. *Lower „ „ „ Erith to outer limits of the Port of London. Total 30,078 COMPARATIVE TABLE. Total number of Inspections of vessels from— 1906. 1907. 1908. 1909. 1910. 1911. 1912. 1913. 1914. 1915. Yearly average for the 10 years ending 31st December, 1915, "Foreign" " Coastwise," " Inland 13,013 17,971 15,258 14,887 13,710 14,015 15,177 14,425 13,539 12,472 14,446.7 Navigation," and other Inspections - 22,335 19,414 20,014 25,469 24,857 24,009 28,035 24,501 24,475 22,237 23,534.6 Total - 35,348 37,385 35,272 40,356 38,567 38,024 43,212 38,926 38,01434,709 37,981.3 46 TABLE XXXI. NUMBER OF NUISANCES ON VESSELS REPORTED AND DEALT WITH during the year ending 31st December, 1915. Description of Nuisances. January. February. March. April. May. June. July. August. September. October. November. December. Totals. Smoke Nuisances :— Number of complaints received 12 2 16 21 7 10 4 ... 10 10 5 7 104 Number of recurrences reported ... ... ... ... ... ... ... ... ..... ... ... ... ... Offensive Cargoes (Bye-laws) :— Number of Infringements reported 12 50 11 2 ... 1 ... ... 4 1 2 ... 83 Structural and other Defects :— Ventilation ... 6 4 2 6 1 3 3 8 2 3 4 8 50 Lighting ... ... 8 18 7 2 1 4 3 4 6 3 11 8 75 Heating ... 7 10 7 1 1 ... ... 1 2 ... 17 7 53 Bare iron in crew's quarters ... 1 1 ... ... ... ... ... ... 1 1 4 Leaky decks, hawse-pipes, cable casings, &c. 7 4 4 2 2 7 3 3 8 2 6 5 53 Defective bulkheads and floors 2 1 1 ... 1 1 ... ... 2 ... ... 2 10 Sanitary conveniences 3 4 4 7 3 3 8 5 2 5 13 4 61 Ship's gear or stores stowed in crew's quarters ... ... ... . - ... ... ... ... 1 ... 1 1 3 Foul bilges and peaks 1 ... ... ... 4 4 7 5 8 1 1 1 32 Storage of drinking water (dirty or defective tanks) 1 1 1 ... ... 1 1 ... 1 ... ... ... 6 Dirty quarters 107 211 262 116 208 240 140 146 181 165 188 176 2,140 Accumulation of offensive matter ... 1 ... 1 6 1 ... ... ... ... 1 ... 10 Miscellaneous Nuisances 2 8 8 4 3 6 1 3 1 1 7 ... 44 Totals 168 315 324 162 237 281 170 175 228 191 257 220 2,728 Total number of vessels on which structural alterations were ordered 17 24 16 10 7 14 12 15 15 8 27 18 183 Total number of vessels on which structural alterations were reported as carried out 3 18 21 6 15 5 17 7 6 3 34 50 185 NUMBER OF NUISANCES IN THE RIVER REPORTED AND DEALT WITH during the year ending 31st December, 1915. From discharge of foul liquid, sewage, &c., into the River ... 1 ... ... ... ... ... ... ... ... ... ... 1 Offensive condition of River water ... ... ... ... ... ... ... ... ... ... ... Totals ... 1 ... ... ... ... ... ... ... ... ... ... 1 47 TABLE XXXII.. NUMBER OF NUISANCES ON SHORE PREMISES REPORTED AND DEALT WITH during the year ending 31st December, 1915. Description of Nuisances. January. February. March. April. May. June. July. August. September. October. j November. j December. Totals. Smoke Nuisances:— Number of complaints received 3 . . . 6 2 ... . . . ... . . . 2 1 ... 3 17 Number of recurrences reported . . . ... ... ... . . . • . . . . . ... . . . . . . . . . ... ... Structural and other Defects :— Ventilation. 1 . . . ... 2 1 . . . ... ... ... ... ... ... 4 Lighting 1 ... ... ... 2 ... ... ... ... ... ... ... 3 Heating ... ... ... ... ... ... ... ... ... ... 1 1 Dilapidations ... ... ... ... 1 3 ... ... 4 1 ... 4 19 Sanitary conveniences ... ... 2 4 6 2 ... 2 1 3 2 ... 22 Water supply ... ... ... ... ... ... ... ... ... 2 ... 2 Dirty premises 38 58 91 46 55 93 54 54 47 62 64 32 694 Accumulation of offensive matter ... ... ... ... 4 1 2 1 1 ... ... ... 9 Drainage ... ... 1 ... ... 1 ... 2 2 ... ... ... 6 Foul cesspits, latrines, &c ... ... 2 1 2 1 1 ... ... 1 ... 2 10 Miscellaneous nuisances .. 1 7 3 3 4 7 3 ... ... ... 1 29 Totals 43 59 109 58 74 105 70 62 57 68 68 43 816 Number of shore premises on which structural alterations were ordered 1 ... 2 6 10 5 4 4 3 3 2 5 45 Number of shore premises on which structural alterations were reported as carried out... ... ... 1 3 4 2 ... ... 2 1 ... 2 15 SUMMARY. Smoke. Structural. Offensive Cargoes. Drainage, Sewage, &c. Miscellaneous. Totals. Number of Nuisances reported— (a) On vessels 104 306 83 2,235 2,728 (b) On shore 17 51 ... 6 742 816 (c) On the River ... ... 1 ... 1 Totals 121 357 83 7 2,977 3,545 Number of written Intimations— (a) On vessels 4 157 83 ... 38 282 (b) On shore 2 20 ... 4 22 48 (c) On the River ... ... ... ... ... ... Totals 6 177 83 4 60 330 Number of Statutory Notices— (a) On vessels ... 4 ... ... ... 4 (b) On shore ... ... ... ... ... (c) On the River ... ... ... ... ... ... Totals ... 4 ... ... ... 4 48 NUISANCES. On the 9th November, complaint was received of the dilapidated and insanitary condition of a barge lying at the Hollows, Brentford. An inspection was made the same day. The barge was used as a dwelling by a man and wife with seven children. The barge was very old, rotten, leaky and in a dirty condition, and quite unfit for use as a dwelling. The owner's attention was called to the nuisance, with the result that the barge was vacated and was no longer used as a habitation. A complaint was received from the Medical Officer of Health for Southend-on-Sea, that various substances have been found on the foreshore of that Borough, which in his opinion had come from the ships lying off Southend, on which German prisoners of war are interned. It was stated that in one place on the foreshore there was an accumulation which consisted of cabbages and leaves, undervests, old boots and boot leather, parts of lemons and oranges, pieces of potatoes, cigarette packets, torn letters, rabbit skins, rabbit heads, and general litter. Your Medical Officer visited Southend, and in company with the Medical Officer of Health and the Chief Sanitary Inspector, made a careful inspection of the foreshore. At the time of the visit there was, however, little or nothing to be seen which formed the subject of the complaint. A letter was sent to the Officer in charge of the ships, stating that complaints had been received, and suggesting that all possible foundation for such should be removed. This might be done by having all refuse from the ships burnt in the ship's furnaces. A reply was received from him stating that he regretted exceedingly that any such complaint should be made against the ships, and that he had taken measures to prevent rubbish of any sort being thrown overboard. As it is probable that the vessels will be removed this month no further complaints should be received. CREW'S QUARTERS. On arrival of the s.s. " Den of Ruthven," of Dundee, 133,323, from Rangoon, it was ascertained that two Natives had been suffocated in their berth, while the vessel was lying off Southend, awaiting orders. On making enquiries, it was found that no heating arrangements had been provided for this berth, and the men had utilised a five-gallon oil drum for the purpose, and that the fumes arising from this improvised heating apparatus had caused death in both cases. The owners were communicated with, recommending the provision of a suitable warming arrangement, with a view to preventing the recurrence of such an event. On the 3rd February, a complaint was received respecting the alleged " bad" accommodation of the s.s. " Flaminian," of Liverpool, 137,386. The vessel was duly inspected, and the conditions found were briefly as follows :— The firemen's quarters are certified for twelve men, and were, at the time of inspection, occupied by eleven men. The cubical capacity and superficial area comply with the minimum Board of Trade requirements. One ventilator is placed over a bunk, 49 and the bunks and bedding were dirty, caused by smoke and dust from the stove. The construction of the forecastle, from a sanitary point of view, would not appear to be good. The sailors' quarters are certified for eight men, and during the voyage, it was stated, were occupied by nine men, an extra bunk having been fitted up across forward bulkhead. A ventilator was used as an outlet for a stove pipe. Cook's berth, certified for three men, occupied by four men. Stewards' berths certified for six men, has only one six-inch ventilator, which is placed immediately over a bunk. Donkeyman's, Storekeeper's, Carpenter's and Boatswain's berths and closets are not properly drained. Third and fourth Engineers' berth opens directly into the engine-room, where the temperature often reached 105 degrees in the tropics. The fourth Engineer's berth was underneath that of the third, and it must have been impossible to sleep in during hot weather. This is a new vessel, and will be employed in tropical climates. The quarters were inspected by your Chairman and Medical Officer, and formal intimation was served upon the owners. The accommodation, &c., provided for the Troops engaged in guarding the dock, have all been inspected, and a few suggestions for improving the same have been made to the Port of London Authority, who have readily agreed to do what is necessary. On an inspection of the s.s. " Oakby," of West Hartlepool, 106,960, the water-closet (of the trough pattern) was found without any means of flushing. The trough was partly filled with soil, and a nuisance. In an interview with the Marine Superintendent of the Company it was pointed out to him how the nuisance could be abated, and any recurrence prevented. TABLE XXXIII. POLICE COURT PROCEEDINGS. January. February. March. April. May. June. July. August. September. October. November. December. Total. Total number of cases in which legal proceedings were recommended ... 3 ... ... ... • • • ... ... ... • • • ... ... 3 Total number of cases in which legal proceedings were taken ... ... ... ... ... ... ... ... ... ... ... ... ... 50 TABLE XXXIV. SANITARY WORKS. Part I. Date completed. Works. 1915. Jan. 19 Millwall Dock—Erection of new Mess Rooms, &c., for women. Mar. 18 London Dock—Erection of sanitary conveniences at 12 Yard. May 7 Surrey Commercial Dock—Erection of sanitary conveniences at Brunswick Yard. June 15 Tilbury Dock—Erection of sanitary convenience for men at Government Transit Shed. July 27 Royal Albert Dock—Construction of new drain for garage at Messrs. Green and Silley Weir's premises. Sept. 28 Tilbury Dock—Erection of latrine accommodation for Lascars. Dec. 7 Regent's Canal Dock, North Quay—Drains for rainwater from New Iron Building. 7 South- West India Dock—Erection of latrine for Lascars, South side. „ 13 *Victoria Dock—Erection of closets at Rank's Mills. * Works completed before plans were submitted, and I did not, therefore, recommend that they be approved by the Committee. Part II. Sanitary Works and alterations, not yet reported as completed :— Date Plan submitted. Works. 1915. Jan. 22 Royal Albert Dock—Proposed latrine for woman cook at rear of Mess Room, No. 35 Shed. March 3 West India Dock, North Quay, Import Dock—Proposed new closet accommodation at Nos. 2 and 9 Warehouses. May 14 Royal Albert Dock—Proposed main drain for Cold Storage New Works. „ 21 Millwall Dock—Proposed sanitary conveniences at Wood Yard Gate. „ 27 Regent's Canal Dock—Proposed drainage of new warehouse. „ 28 Royal Albert Dock—Proposed new drain and water closet for Messrs. Lester and Perkins' premises. July 17 Surrey Commercial Dock—Proposed drain and surface water gully at Brunswick Yard. Aug. 10 St. Katharine Dock—Proposed improvement in lavatory accommodation at " E " Warehouse. „ 10 London Dock—Proposed improvement in lavatory accommodation at Crescent Warehouses. Oct. 6 Millwall Dock, South Side—Proposed re-erection of sanitary conveniences at " Z Shed. Nov. 5 West India Dock (Import Dock), North Quay—Proposed storm water overflow to sewer. „ 10 Tilbury Dock, Main Dock Extension—Proposed closets and urinals. Dec. 15 Surrey Commercial Docks—Proposed additions to sanitary conveniences for women clerks.- The following offices were erected, and drains laid within the district of the Port of London Sanitary Authority, in the Royal Albert Dock :— The Shaw, Savill and Albion Company's Offices :— No. 5 Group Office. No. 7 Group Office. Workmen's premises. The Atlantic Transport Company's Premises :— His Majesty's Customs No. 12. Temperance Catering Company's Coffee Rooms. No plans or particulars were submitted for the approval of your Worshipful Committee. 51 TABLE XXXV. BYE-LAWS—OFFENSIVE CARGOES. Eighty-three cases of infringement of the above-mentioned bye-laws were reported during the year. In each case written notice was sent to the owners of the barges concerned :— Date. Name of Vessel. Infringement. 1915. Lighter " Poppy " Loaded with a cargo of house refuse which was not properly and securely covered so as to prevent any nuisance arising therefrom. Jan. 5 12 Dumb Barges "Violet" and "Anglo-American " Loaded with a cargo of house refuse which was not properly and securely covered so as to prevent any nuisance arising therefrom, and was also loaded above the Jan. 27/28/ 29, Feb. 1/ 2/3/4/5/8/9/ 10/11/19 Lighter "Baden Powell" coamings. Ditto Ditto. Jan. 27, Feb. 4/5/8/ 9/10/11/19 Lighter " Lily " - Ditto Ditto. Jan. 27/28/ 29, Feb. 1/ 2/3/4/5/8/9/ 10/11/19 Lighter " Mary " Ditto Ditto. Jan. 28 Lighter " Pretoria ' - Ditto Ditto. „ 28 Lighter "Lily" (Shepherd) Loaded with a cargo of house refuse which was not properly and securely covered so as to prevent any nuisance arising therefrom. Feb. 4/5/8/ 9/10/11/19 Lighter " Clara " - Loaded with a cargo of house refuse which was not properly and securely covered so as to prevent any nuisance arising therefrom, and was also loaded above the coamings. Feb. 5 Lighter " Kit" - Ditto Ditto. „ 5 Lighter " George " Ditto Ditto. „ 5/9/10 Lighter " Demond " Ditto Ditto. 5 Lighter " Pansy " Ditto Ditto. „ 5/8 Lighter " J ess " - Ditto Ditto. , 9/10 Lighter " Louise " Ditto Ditto. „ 9/10 Lighter " Ruth " - Ditto Ditto. Feb. 24 Lighter " Louise " Ditto Ditto. „ 24 Lighter " Demond " Ditto Ditto. „ 27 March 8 Lighter " Pretoria" A cargo of house refuse loaded above the coamings. Feb. 27 Lighter " Blackfriars " - Ditto Ditto. March 2 Lighter " Clara " - Loaded with a cargo of house refuse which was not properly and securely covered so as to prevent any nuisance arising therefrom, and was also loaded above the coamings. „ 2/5 Lighter " Lily " - Ditto Ditto. 52 Date. Name of Vessel. Infringement. 1915. Lighter " Baden Powell" Loaded with a cargo of house refuse which was not properly and securely covered so as to prevent any nuisance arising therefrom, and was also loaded above the coamings. March 2/5 „ 2/5 Lighter " Mary " - Ditto Ditto. 8 Lighter " Flora " - Ditto Ditto. 8 Lighter " Ebury " Ditto Ditto. 8 Lighter " Wandle " Ditto Ditto. April 13/14 Dumb Barge " AngloAmerican." Loaded with an offensive cargo, to wit, refuse matter, permitted or allowed to remain within the district of the Port of London Sanitary Authority for a longer period than 48 hours. June 29 Lighter "Passionflower Loaded with an offensive cargo, to wit, road sweepings, which was not properly and securely covered so as to prevent any nuisance arising therefrom. Sept. 23 Lighter " Hawthorn " - Loaded with a cargo of house refuse and road sweepings not properly and securely covered so as to prevent any nuisance arising therefrom. „ 23 Lighter " Hemlock " - Ditto Ditto. „ 24/5 Lighter " May " - Loaded with a cargo of fish refuse not properly and securely covered so as to prevent any nuisance arising therefrom. Oct. 7 Lighter " Mayflower" - Loaded with a cargo of house refuse and road sweepings, not properly and securely covered so as to prevent any nuisance ariving therefrom. Nov. 11 Lighter " Cornflower " - Loaded with an offensive cargo, to wit, road sweepings and house refuse not properly and securely covered so as to prevent any nuisance arising therefrom. 12 Lighter " Whitethorn " Ditto Ditto. It will be noticed that there are several infringements of the Bye-laws relating to Offensive Cargoes. The usual notices have been served upon the owners who state, in explanation, that:— " They are unable to obtain delivery of cloths." " They have difficulty in getting labour to enable them to clear the barges as fast as usual, and that, moreover, the various Vestries, in order to keep their wharves clear of refuse, load their barges above the coamings." FUMIGATING APPARATUS, BARGE "THOMAS." The fumigating plant was used on 6 occasions during the year, the largest ship fumigated being one of 4,931 tons, with a cubic capacity of 353,880 cubic feet. TABLE XXXVI. Date. Name of Vessel. Capacity in Cubit Feet. 1915. Feb. 1 s.s. " Spectator " 268,000 23 s.s. " India " - 201,555 June 8 s.s. " Persia 158,200 Oct. 10 s.s. " Koeber 300,000 Nov. 30 s.s. " Beechwood " 161,000 Dec. 13/14 s.s. " Director" 353,880 53 LAUNCHES. A scheme for the more economical working of the launches, in view of the scarcity of suitable coal and reduction of staff, became necessary. The " Lady Truscott " was withdrawn from ordinary inspections. The " David Burnett " was placed on the Gravesend Station, whilst the Upper and Middle Districts were worked by the "George Briggs." It was thus possible to dispense with the services of the temporary stoker on the "Lady Truscott" and the temporary deckhand on the " David Burnett." The new arrangement was put into force on the 29th March. Two launches, therefore, have been doing work usually done by three. Of the launch crews, consisting of ten men, four have joined the Colours and one has resigned, thus reducing the original staff by half. HULK " HYGEIA." During August the hulk was found to be leaking. The hulk was placed in dry dock, and on examination there were found some leaky bolts and trenails, and some defective planks in the bottom. The seams also required recaulking. These repairs were carried out, but in September the hulk again sprung a leak and soon had six feet of water in the hold. By pumping she was kept afloat, and was again put into dry dock when further defective planks and seams were found. These having been put right, no further trouble has arisen. The hulk, however, is of wood, and old, therefore likely in future to give further trouble of the kind referred to. PORT OF LONDON. The limits of the Port of London as at present defined commence at High Water Mark in the River Thames at Teddington Lock, in the County of Surrey, and extend down both sides of the River Thames to an imaginary straight line drawn from the Pilot Mark at the entrance of Havengore Creek, in the County of Essex, to the Lands end at Warden Point, in the Isle of Sheppey, in the County of Kent, such point being the North-Western limit of the Port of Faversham, and shall extend up and include both sides of the River Medway to an imaginary straight line drawn from the SouthEast point of land westward of Coalmouth Creek, thence across the said River Medway to the Westernmost point of the piece of land which forms the Eastern side of the Stangate Creek, or, in other words, the North-West point of Fleet Marsh, and from thence in a Southerly direction to Iwade Church, in the said County of Kent, and thence in a North-Easterly direction to Elmley Chapel, in the said Isle of Sheppey, a supposed direct line from Elmley Chapel to Iwade Church, being the Western limit of the Port of Faversham, and the said Port of London shall include the Islands of Havengore Creek aforesaid, called Potton and Rushey Islands, and so much of the said Creek and watercourse as extends from it to the town of Rochford, and shall also include all other islands, rivers, streams, creeks, waters, watercourses, channels, harbours, docks and places within the before-mentioned limits contained. 54 CANAL BOATS ACTS. In accordance with Section 3 of the Canal Boats Act, 1884, I beg to present herewith the Annual Report on the working of the Canal Boats Acts and Regulations within the district of the Port of London Sanitary Authority, during the year ending 31st December, 1915. The Acts and Regulations apply within the whole of the district under the jurisdiction of the Port of London Sanitary Authority, including the river and docks —as a "canal," for the purposes of the Act, includes any river, inland navigation, lake, or water being within the body of a county, whether it is or is not within the ebb or flow of the tide. The navigation in addition to the enclosed docks, includes the following navigable tributary waters and creeks of the River Thames :— On the right bank from Teddington downwards :— Wandsworth Creek (River Wandle). Part of the Grand Surrey Canal within the Surrey Commercial Docks. Hay's Dock. St. Saviour's Dock. Deadman's Dock. Deptford Creek (River Ravensbourne). Dartford Creek (Rivers Cray and Darenth). The entrance to the Gravesend Canals. Cliffe Creek. Yantlet and Coalmouth Creeks. Part of the river Medway, and of the Swale. On the left bank from Teddington downwards :— The entrance to the River Brent. Chelsea Dock. Grosvenor Dock. Limekiln Creek. Part of the River Lea. Barking Creek (River Roding). Rainham Creek (River Ingrebourne). Mucking Creek. Thames Haven. Hole Haven. Potton and Rushley Creeks. River Roach as far up as Rochford. The whole of this area is divided into three districts, known as the Upper, Middle and Lower, each district being in charge of an Inspector, as follows :— RIVER. Upper District. Teddington to Greenwich. Inspector Lambe 208/, per annum. Inspector Shepherd 156/. ,, 55 Middle District. Greenwich to Erith. Inspectors Lambe and Shepherd. Lower District. Erith to seaward limits of the Port of London (including part of the River Medway). Inspector Berry 130/. per annum. The Docks are divided into four districts, known as the Central, Eastern, Western and the Gravesend district. Central District. West India Dock. South West India Dock. Poplar Dock. Millwall Dock. Inspector Rolfe -220/. per annum. Eastern District. Royal Victoria Dock. East India Dock. Inspector Garland 220/, per annum. Inspector Burr 220/. ,, Royal Albert Dock. Inspector Wetjen 220/. per annum. Western District. London Dock. St. Katherine's Dock. Regent's Dock. Inspector Hopkins 220/. per annum. Surrey Commercial Dock. Inspector Elward 188/. 10s. per annum. Gravesend District. Tilbury Dock. Left Shore, from Purfleet down. Right Shore, from Erith down. Inspector Massie 182/. per annum. (2) The total number of inspections for the year was 413, representing a net number of 197 boats. The remainder, 216, represents repeated visits by Inspectors of this Authority. The number of boats not conforming to the Acts and Regulations was 55 (inspected on 85 occasions, or 13.31 per cent. of the total inspections, the percentage for the previous five years being 8.98 per cent.). 56 In addition to the above, 7 boats were at the time of visit found with the cabin doors locked, there being no person on board. Inspection was therefore impossible, and these visits are not included in the number of boats inspected. (3) With reference to the various infringements of the Act :— Unregistered Boats. The following boats were found, on inspection, to be unregistered within the meaning of the Act:— Date. Name'of Boat. Registration Authority. Reason for Registration or Re-registration. 1915. Jan. 10 " Richard " -• New Boat. Feb. 11 *" Tricot" Port of London Ditto. March 11 '• Richard " Ditto. May 19 " Constant" - Ditto. Notused as a resident craft. „ 19 " Taycrone " . Registered under Merchant Shipping Act. New motor barge. June 10 " Sandford " - New Boat. July 7 " Richard " - Ditto. „ 10 *" William" Port of London Change of Ownership. „ 12 " Richard " New Boat. „ 19 *" Tricot" Port of London Ditto. Aug. 6 *" Maypole, No. 1" Ditto Ditto. „ 6 *" Maypole, No. 2 " Ditto Ditto. „ 6 *" Maypole, No. 3 " Ditto Ditto. 6 *" Maypole, No. 4 " Ditto Ditto. „ 19 *Ruby" Ditto Ditto. Sept. 13 " Sandford " . Ditto. „ 13 "Richard" . Ditto. „ 16 *" Ruby " Port of London Ditto. „ 29 " Sandford " Ditto. „ 29 " Richard " Ditto. Oct. 22 *"Ruby" Port of London Ditto. Nov. 18 *" Oil Tar " Ditto Ditto. „ 24 *" Oil Tar " Ditto Ditto. These marked * were registered with this Authority. With regard to the " Richard" and " Sandford," these boats have not been inspected since September. Notification of Change of Master. Nil. 57 Certificates. Absence of certificate was found in the following cases, a complaint being sent to the owners. In the case of the boats marked * information was received that the Certificates were subsequently placed on board :— 1915. Feb. 3 *" Thrift" Registered Limehouse, No. 4. 3 * " Harry " ,, Berkhamsted, No. 486. Mar. 5 " Rickmansworth " „ Brentford, No. 313. 29 *" Cicero" „ Uxbridge, No. 480. 29 " Stanley " „ Port of London, No. 271. May 7 "Martin" „ Reading, No. 27. 13 " Wm. and Henry " „ Berkhamsted, No. 324. „ 29 * " Walter " „ „ No. 343. 29 * " Lansdowne " „ Uxbridge, No. 443. June 8 * " Trent " „ „ No. 392. 21 * Trent " „ „ No. 392. July 8 * " Lansdowne " No. 443. 16 * " Trent" „ „ No. 392. 22 j, uu * " Stour „ „ No. 419. 28 * " Stour " „ „ No. 419. Aug. 24 * " Lansdowne " „ No. 443. Sept. 17 * " Eliza " „ Berkhampsted, No. 279. Nov. 5 " Andree" „ „ No. 255. Dec. 16 * " Stour " ,, Uxbridge, No. 419. Certificates not Identifying Owner with Boat. 1915. July 28 "Lucy" registered Uxbridge, No. 386. Marking, &c. The following boats were found infringing in this respect. Those marked * were remedied :— 1915. "Victor" registered Uxbridge, No. 470. Jan. 12 * May 13 " Wm. and Henry " ,, Berkhamsted, No. 324. Aug. 19 * "Tiny" „ Brentford, No. 333. Sept. 2 * " Nansen " ,, Berkhamsted, No. 261. 30 * " Oxford City " ,, Port of London, No. 449. Oct. 5 " Mary " „ Brierley Hill, No. 144. Overcrowding. 1915. June 17 *"Cyril" - registered Brierley Hill, No. 226. The canal boat " Cyril," registered Brierley Hill, No. 226, was inspected on the 17th June, 1915, and found to be registered for 3 adults aft, and 1 forward. At the time of inspection, the after cabin was occupied by the master, his wife, and 3 children. A complaint was sent to the owners on the 18th June, and on the 12th July I received information that the complaint had been remedied. Separation of the Sexes. Nil. Males over Age. Females over Age. 1915. June 24 *"Fera" registered Brierley Hill, No. 236. The canal boat " Vera," registered Brierley Hill, No. 236, was inspected on the 24th June, and found to be registered for 3 adults aft. The after cabin was occupied by a male above the age of 14 years, and two females above the age of 12 years, in contravention of the Canal Boat Regulations. A complaint was sent to the owners, and on the 12th July I received information that the complaint had been remedied. 58 Cleanliness. The following boats were found to require cleansing, and those on which the necessary improvement was made, are marked * :— 1915. March 29 " Stanley " registered Fort of London, No. 271. „ 29 *" Isis " „ „ „ No. 468 31 " Diligent" „ Brentford, No. 65. April 8 " Crawford „ Uxbridge, No. 412. 12 " Freda " „ Brentford, No. 310. 26 *" Brimo " „ Reading, No. 20. May 19 " Constant" (unregistered.) June 11 •"May" registered Brentford, No. 250. „ 25 *"Isis" „ Port of London, No. 468. Nov. 18 *" Oil Tar " registered Port of London. Painting. The following boats were found to require painting with regard to the interior of the cabin, which was done in the cases marked * :— 1915. Jan. 25 *" Wasp " registered Brierley Hill, No. 158. Feb. 9 •" Franklin " „ Berkhamsted, No. 338. March 19 *" Harry " „ Brentford, No. 214. May 19 "Alert" „ Port of London, No. 239. 19 " Constant" (unregistered.) June 11 •"May" registered Brentford, No. 250. 24 *" Vera " „ Brierley Hill, No. 236. July 8 *" Livingstone " „ Berkhamsted, No. 325. Sept. 2 "Nansen" „ „ No. 261. Oct. 4 " Sarah " „ „ No. 408. Nov. 16 "Alert" „ Port of London, No. 239. 30 " Nansen " „ Berkhamsted, No. 261. Ventilation. The following boats were found to require better ventilation. Those in which the alterations have been made, are noted thus* :— 1915. *" Tricot" registered Port of London, No. 471. Feb. 11 May 19 " Constant" (unregistered.) June 3 *" Nellie " registered Brentford, No. 192. July 12 " Richard " (unregistered.) Sept. 29 "Richard" " Oct. 4 " Sarah " registered Berkhamsted, No. 408. Nov. 30 " Nansen " No. 261. Dilapidation. 1915. " Alice " registered Brentford, No. 305. Jan. 20 Feb. 8 *" Nansen " ,, Berkhamsted, No. 261. 9 *" Franklin " „ No. 338. March 4 *" Trent" „ Uxbridge, No. 392. 5 " Sarah Ann " „ Reading, No. 34. 19 *" Harry " ,, Brentford, No. 214. „ 29 " Stanley " „ Port of London, No. 271. „ 31 " Diligent" „ Brentford, No. 65. 59 1915. April 8 " Crawford " registered Uxbridge, No. 412. „ 12 " Freda " „ Brentford, No. 310. 16 *" Frank " ,, Reading, No. 40. May 11 *" Perseverance " „ Port of London, No. 233. 13 " Wm. and Henry " ,, Berkhamsted, No. 324. 19 " Alert" " ,, Port of London, No. 239. „ 19 "Constant" (unregistered.) 19 " Jane " registered Reading, No. 41. June 3 *" Nellie " „ Brentford, No. 192. 11 *" May " No. 250. 12 " Grwynne " „ Reading, No. 28. 12 *" Providence" „ Port of London, No. 292. „ 22 " Sarah Ann" ,, Reading No. 34. 25 *" Sarah " „ Berkhamsted, No. 408. July 9 *" Providence " „ Port of London, No. 292. Sept. 22 " Leeds" „ Berkhamsted, No. 273. 29 " Sandford" (unregistered.) „ 29 "Bichard" J! Oct. 4 " Sarah " registered Berkhamsted, No. 408. „ 23 " Carson " „ Uxbridge, No. 486. „ 25 *" Nansen " „ Berkhamsted, No. 261. Nov. 5 "Andree" No. 255. 12 " Leeds " No. 273. 12 " Eliza " No. 279. 16 " Alert" ,, Port of London, No. 239. 18 *" Oil Tar" ,, ,, ,, 30 " Nansen " „ Berkhamsted; No. 261. 8 " Andree " No. 255. 18 " Walter " „ „ No. 345. Removal of Bilge Water. Nil. Provision of Water Cask. The following boats were not provided with proper vessel for containing drinking water. In the cases marked * I received information that this had been done :— 1915. Jan. 10 *" Richard " (unregistered.) June 10 " Sandford " ( „ ) Aug. 6 " Maypole " No. 1, registered Port of London. ,, 6 " Maypole " No. 2, „ „ ,, 6 "Maypole" No. 3, ,, ,, 6 " Maypole" No. 4, „ „ Sept. 29 " Sandford " (unregistered.) Nov. 18 •" Oil Tar " registered Port of London. Notification of Infectious Disease. Nil. Other Illness. On the 2nd November, a paragraph appeared in the press stating that four children had been suffocated as the result o£ a fire on a barge at Brentford. Enquiries were made respecting this, and it was ascertained that the barge concerned was the canal boat " Trent," registered Uxbridge No. 392, and owned by Mr. Emanuel Smith, of Brentford. 60 This boat is registered for four adults aft, and was occupied by the master, his wife, and four children, and carried a part cargo of wool. The children were put to bed at 8 p.m. on the 1st November, and were left on board, the master leaving at 8.30 p.m. and his wife at 9.15 p.m. A swinging lamp was left hanging in the cabin. At 11 p.m. the master and his wife returned and found the cabin full of smoke, the children on being taken out of the cabin, were found to be dead. A doctor was summoned, and he pronounced life to be extinct. It would appear that the cabin lamp fell down from the hook on to a flock bed in the cabin, thus causing the fire. Admittance of Inspector. No difficulty has been experienced in regard to the visits of the Inspectors of this Authority. Legal Proceedings. Nil. (5) The total number of infringements found was 126 on 55 boats, inspected on 85 occasions. Formal notice of each infringement was at once given to the owners, and in many cases they were remedied without further complaint. The number of written notices was 69, and the number which has been certified as attended to was 54. This number includes 18 infringements found in previous years, and reported remedied in 1915. Of the complaints issued in the year now under review, 52.17 per cent. were remedied. Double Bulkheads. (6) There were no infringements with regard to the provision of these. (7) No boats have been detained for cleansing:. (8) On December 31st, 1915, there were 262 boats on the Register:— Propelled by Tug and Oars 244 „ „ Steam 15 „ ,, Motors 3 262 (9) Eight boats were registered in 1915. Of these, 7 were new boats. Table of Canal Boats Carrying Children on Board. Year. No. of boats. No. of boats with children. No. of children. Average No. of children per boat. Average No. of boats with children. 1908 - 1,168 206 459 2.18 17.63 1909 - 1,432 219 495 2.26 15.29 1910 - 908 172 354 2.05 18.94 1911 - 926 173 400 2.31 18.03 1912 - 841 197 409 2.07 23.42 1913 - 451 61 196 3.21 13.52 1914 - 237 82 214 2.60 34.62 1915 - 197 56 256 4.57 21.52 I have the honour to be, Gentlemen, Your obedient Servant, W. M. WILLOUGHBY, Medical Officer of Health, Port of London 61 TABLE XXXVII. SUMMARY OF CANAL BOATS FOR THE YEAR ENDING 31ST DECEMBER, 1915. Janoary. February. March. April. May. June. July. August. September. October. November. December. TOTAL. 1910. total 1911. for thE 1912. year 1913. 1914 New boats registered ... ... ... ... ... ... 1 ... 4 1 1 7 2 6 2 3 3 Registration owing to structural alterations ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Registration for other purposes ... ... ... ... ... ... 1 ... ... ... ... ... 1 1 ... ... ... 5 No. of Visits of Inspection 33 44 47 33 28 41 34 35 40 29 30 21 413 878 889 817 576 571 Conforming to Acts and Regulations 29 39 38 29 19 29 23 26 31 24 23 18 328 807 800 692 506 473 Infringements in respect to :— Registration 1 1 1 ... 2 1 4 5 5 1 2 ... 23 4 8 9 4 20 Notification of change of master ... ... ... ... ... ... ... ... ... ... ... ... ... 1 2 ... ... 1 Absence of certificate ... 2 3 ... 4 2 4 1 1 ... 1 1 19 20 44 34 17 18 Certificate not identifying owner with boat ... ... ... ... ... ... 1 ... ... ... ... 1 2 5 4 4 Marking, &c. 1 ... ... ... 1 ... ... 1 2 1 ... ... 6 9 18 11 7 14 Overcrowding ... ... ... ... ... 1 ... ... ... ... ... ... 1 2 5 5 1 1 Partition separating sexes ... ... ... ... ... ... ... ... ... ... 1 ... 2 ... ... Males over age ... ... ... ... ... 1 ... ... ... ... ... ... 1 ... ... 2 ... Females over age ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... ... ... Cleanliness ... ... 3 ... 1 2 ... ... ... ... 1 ... 10 14 12 23 11 14 Painting 1 1 1 ... 2 2 1 ... 1 1 2 ... 12 9 19 17 17 23 Ventilation ... 1 ... ... 1 1 1 ... 1 1 1 ... 7 3 5 8 6 6 Dilapidation 1 2 5 ... 5 6 1 ... 3 3 6 2 37 27 33 68 39 52 Removal of bilge water ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 3 4 2 Without pump ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Refusal to admit Inspector ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... No proper water vessel 1 ... ... ... ... 1 ... ... 1 ... 1 ... 8 5 ... ... 8 7 Without double bulkhead ... ... ... ... ... ... ... . . . ... ... ... ... ... ... ... ... ... Notification of infectious disease ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Detained for cleansing ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Proceedings taken ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 2 Cautions given 3 5 8 3 7 10 6 7 8 4 5 3 69 33 70 97 59 79 „ attended to 5 2 2 1 3 5 20 5 2 10 9 54 46 49 74 55 81 Total registered by Port Sanitary Authority since 1887 477 Cancelled 215 Actual number on the Register, 31st December, 1915 262 Registered for 1,560 persons. Carrying males 588. females 174. children 256. 62 Appendix A, NOTES on an Epidemic of Small-pox, by the Medical Officer in charge of Denton Hospital, 1915. VARIOLA SINE ERUPTIONE. The epidemic of Small-pox here recorded, derives a special interest from what appears to me to be clear evidence of Small-pox without eruption, in two of the cases. Clear evidence in such cases must of necessity be very much rarer than occurrence of the cases. Osier, in 1897 wrote, " I do not remember to have met with an instance of this kind or to have heard of one " ; yet on analogy with every exanthematous disease such cases should be by no means rare in times of epidemic Small-pox. The facts are as follows : a party of ten persons, five vaccinated and five unvaccinated, boarded a homeward-bound vessel at Port Said. C.L., male, aged ten years, was taken ill, and the rash of Small-pox appeared on January 28th. The ship's surgeon was called to see the boy on January 31st. The party of ten persons was segregated from the passengers and crew on February 1st. The case was landed into the Port of London Isolation Hospital on February 7th, where the remainder of the ten were content to remain and await the developments of which they were warned. Rash appeared in succession on the remaining four unvaccinated children on the 11th, 13th, 14th and 15th February. These children were all under eight years of age. Two of the ship's company showed the first sign of rash on the 12th and 13th February respectively, and were forthwith removed to the hospital. On February 10th a well-vaccinated girl of the party, aged 13, was found to have fever, slight headache, and want of appetite. The temperature became normal on February 13th—no eruption appeared. On February 11th the father, aged 40, poorly vaccinated and just as poorly revaccinated twenty years ago, felt dizzy, and was found to have fever : his symptoms were fever, nausea, and severe backache. The onset was quite sudden. His temperature became normal on February 14th, and no eruption appeared. There are thus two cases of fever to be added to the former six, occurring contemporaneously with these, of duration equal to the usual invasion period, and presenting pre-eruptive symptoms of Small-pox, the one vaguely, the other markedly. These two persons, father and daughter, shared the nursing of the first case on the ship and constitute the cases which are presented as Variola Sine Eruptione. 63 SMALL-POX. Table I. Name. Age. Sex. Date of Illness. Date of Rasli. Date of Infection. C. L. Years. 10 M. 28th January 14th January. M. L. 13 F. 11th 14th February No rash Mr. L. 40 M. 12th-14th No rash P. L. 8 M. 8th „ 11th February 28th January. G. C. 20 M. 10th „ 12th 29th „ M. L. 4 F. 11th „ 13 th 30th „ R. H. 38 M. 11th 13th 30th „ M. L. 6 M. 11th 14th 31st „ C. L. 1 2 M. 12th 15th 1st February. It is seen from the calculated dates of infection—14 days after appearance of the rash, that each case was infected before the illness of C. L. was brought to the notice of the ship's surgeon and before segregation of the party of 10 was arranged for. The 2nd saloon accommodation formed the segregation quarters. C. C. was the 2nd saloon barman, and R. H. a quartermaster, who had made friends with the children, so that both of these men had been particularly exposed to infection. Table 11. Name. Age. Sex. Vaccination. Nature of case. Primary. Secondary. C. L. Years. 10 M. No ne. Severe confluent. M. L. 13 F. ½ sq. in. Sine eruptione. Mr. L. 40 M. 1/8sq. in. 1/8 sq. in. Sine eruptione. P. L. 8 M. No ne. Confluent. C. C. 20 M. 2 sq. ins. Mild, discrete, abortive. M. L. 4 F. No ne. Discrete. R.H. 38 M. sq. in. Severe confluent. M. L. 6 M. No ne. Severe confluent (died). C. L. 1 2 M. No ne. Hemorrhagica Pustulosa (died). The vagaries of the disease as regards vaccination or want of it, are shown in the case of M. L., aged four, who though of the same blood as the other unvaccinated children and infected with the same strain of virus, presented a comparatively mild attack. The case of R. H., who had to some extent outworn his immunity from Smallpox, but in whose case I would have from the first given a prognosis of certain and early death save for his childhood vaccination, has been further noted below. Otherwise the epidemic assumed a character in accord with the protective effects of vaccination. It will be noticed that of the party of ten persons the five unvaccinated took Small-pox and two of these died ; of the five vaccinated, two only took Small-pox, the cases of Variola Sine Eruptione. 64 FACTITIOUS INTENSIFICATION OF RASH. R. H., ship's carpenter, aged 38, presented as severe a case of confluent Small-pox as I have seen recover. He was seen at the earliest onset of his rash after two days of " Influenza " when only thick-sown pin-point flecks were apparent, and these on the scalp only. Sixteen hours later these had progressed but little. At the end of twentyfour hours, however, the scalp was entirely covered by confluent papules, the face was uniformly red, and flecks and papules were apparent on the body and hands. This curious early distribution and a new growth of fine hairs on the otherwise bald head suggested a question at a venture. In answer, it transpired that the lotion he had been rubbing into his head—and incidentally into his hands, face, and possibly other parts of his body, for one towel does much duty in a " fo'c'sle "—had been guaranteed to " bring hair on a billiard ball." Over and above the usual peripheral distribution of Small-pox, which is in itselt " factitious " in that the incidence of the rash depends to a large extent on rubefaction of the exposed peripheries during the invasion stage, nearly every case presents some area of the body in which special " factitious intensification " of the rash and the causal act producing this can be traced. It is impossible to doubt that in this case the strong rubefacient used during the stage of invasion was responsible for the complete wrecking of the whole epidermis of the face, head, neck and hands, and for a condition from which, on maturation, recovery was both protracted and precarious. To those who have the care of "contacts," and thus of cases in the earliest stage of invasion, the above case would suggest that a regimen involving the prevention of any rubefaction of the skin during this stage, will prevent in some measure the severity of the rash incidence, and is an essential part of the treatment. 65 ADMINISTRATION OF THE PORT OF LONDON (PUBLIC HEALTH ACT, 1891). Dr. REVENUE ACCOUNT for the Year ended 31st December, 1915. Or. £ «. d. £ «. a. £ s. d. £ s. d. To Salaries, viz.:— By Proceeds of Sale of Unsound Food (see contra) 1,479 1 10 Dr. H. Williams, Medical Officer of Health 1,000 0 0 ,, Sundry Fees, viz. :— Assistant Medical Officers :— Health Certificates 16 16 0 Dr. W. M. Wilougnby £500 0 0 Metropolitan Asylums Board, under 1891 Act 1 10 0 Ditto 109 4 0 Canal Boats Registration 2 15 0 W.D. Betenson 437 10 0 Disinfections 109 10 0 E.V.Legge 412 18 0 — 130 11 0 A.Kidd 412 10 0 1,884 14 0 „ Refund of proportion of Medical Officer of Health's Salary by Rochester Port Sanitary Authority 100 0 0 W. J. Albrow, Clerk 300 0 0 „ Sundry Reimbursements 7 7 9 3,184 14 0 „ Balance to General Revenue Account 12,247 7 8 „ Uniforms 155 6 10 „ Fidelity Guarantees 1 16 0 „ National Health Insurance 16 5 6 „ Wages, per Medical Officer, viz.:— Offices 479 8 7 Inspectors 2,852 4 2 Launch Crews 1,310 3 1 Hospital Staff 300 12 2 War Bonuses 59 19 5 5,002 7 5 Less Re-imbursement of Wages 8 13 6 4,993 13 11 ,, Workmen's Compensation 11 6 8 „ Contributions to Officers' Pension Fund No. 1 87 17 11 „ Ditto No. 2 251 9 10 339 7 9 „ Ditto Re Pensions 80 15 5 „ Pensions 552 3 0 ,, Disbursements, per Medical Officer, viz. :— 972 6 2 / Petty Cash Expenses, Inspectors and others 316 18 7 / Postage Stamps 48 0 0 / Sundry Office Expenses 16 18 6 / 381 17 1 / ,, Expenses at Greenwich, viz. :— / Rent 55 0 0 Rates and Taxes 19 11 0 Fire and Boiler Insurance 1 10 5 / Telephone Rent 20 10 0 j Gas 12 13 3 J Coal 6 9 8 j Water 2 6 0 Repairs 18 2 9 136 3 1 / „ Expenses of Steam Launches, Hulk, &c., viz .:— 1 Insurance 141 0 8 / Coal and Coke 352 13 6 / Petrol £165 7 2 / Less Rebate on Motor Spirit 23 2 6 / 142 4 8 / Stores 129 8 4 / Repairs £295 12 7 / Special Works, Towing, &c. 391 7 8 / 687 0 3 ■ Less Reimbursement for damage 104 17 3 / 582 3 0 / — 1,347 10 2 „ Hospital at Denton, viz. :— Expenses of extra Nurses 152 13 2 J Rent of Causeway, &c 18 5 0 1 Rates and Taxes 63 1 5 Fire and Boiler Insurance £7 19 5 Aircraft Ditto 7 10 5 j 15 9 10 / Telephone Rent 13 5 0 / Gas 78 15 4 / Coal 42 17 7 / Stores ... 83 10 4 General Repairs 206 7 7 Wall Scot 19 1 0 j Maintenance of Patients 125 12 5 j 818 18 8 I „ Printing and Stationery 72 13 4 „ Telegrams and Maintenance of Private Wire 16 4 2 j ,, Examination of Rats, &c 301 9 0 / .. Condemning Unsound Food, Expenses ... 20 8 1 / Proceeds of sale of Unsound Food returned to Consignees (see contra) 1,174 0 0 / „ Disinfectants 52 7 5 / „ Subscriptions 20 6 0 / „ Advertisements 7 15 8 / „ Medical Examinations re new Appointments 1 11 6 / „ Miscellaneous 12 19 10 / „ Mr. Hallkeeper, Disbursements 0 6 11 / Committee's Allowance ... ... ... 139 0 11 / „ Ditto re Inspection of River 125 7 4 It £13,964 8 3 E13.964 1 8 ! 3 Chamber of London, 1st April, 1916. ADRIAN POLLOCK, Chamberlain. Charles Skipper and East. Printers, 49, Great Tower Street, E.C.